Family planning knowledge and practice among people living with HIV in Nepal.

Shiva Raj Mishra,Vishnu Khanal,Mahesh Prasad Joshi,Julian W. Tang

doi:10.1371/journal.pone.0088663

Shiva Raj Mishra, Vishnu Khanal + Show 2 more

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https://doi.org/10.1371/journal.pone.0088663

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Abstract

Unsafe sexual behavior is common among the HIV infected. This exposes them to the risks of unintended pregnancy, HIV transmission to uninfected partners and super-infection. Studies on the use of family planning measures among People Living with HIV (PLHIV) are scarce in Nepal. The aim of this study was to explore the knowledge and practice of family planning (FP) in PLHIV. A cross sectional survey was conducted during July–December 2012 in Kaski district of Nepal. A total of 120 PLHIVs were recruited using snowball sampling from three HIV clinics within the Pokhara sub-metropolitan city area. This study found that nine in ten PLHIV had heard about family planning. Two thirds of respondents were using at least one FP method. The majority (65.8%) used condoms and had received FP counseling (67.5%). Less than one percent used condoms in addition to another contraceptive. Being single, being female and having received the counselling sessions were associated with the use of FP. The individuals who received FP counseling were more likely [OR 4.522; 95% CI (1.410–14.504)] to use FP. Females were more likely [OR 4.808; 95% CI (1.396–16.556)] to use FP than males. The individuals who were single/de-facto widowed were more likely [OR 7.330; 95% CI (2.064–26.028)] to use FP than the married individuals. Our findings suggest that there is a need to focus on FP counseling if the HIV prevention program is to increase FP use among the PLHIV population. Use of dual contraceptives need to be promoted through counseling sessions and other health promotion programs focusing in HIV prevention.

Highlights

There are an estimated 33.4 million people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) [1]
A significant proportion of people living with HIV (PLHIV) are in Asia, in the Indian subcontinent [2]
This study reports the knowledge, practice and factors associated with family planning (FP) use among PLHIV in Nepal

Summary

Introduction

There are an estimated 33.4 million people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) [1]. The population of Nepal was 26.6 million in 2012. It has grown by more than three million since 2001 and has nearly doubled in the past 25 years. Large and growing cohorts are entering into their reproductive years and the need for reproductive health services is increasing. The use of contraceptives in Nepal has increased more than ten-fold over the past 30 years– from 3.0 percent in 1976 to 43 percent in 2011 with noted decline between 2006 and 2011 [4] [5,6]. Government health facilities are the major (69%) providers of FP services in Nepal [5]

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