Abstract
The postnatal period is critical to the delivery of interventions aimed at improving maternal health outcomes. This study examined the timing to resumption of sexual intercourse and associated factors among postnatal women living with HIV (WLWH) in Uganda. A sample of 385 women was drawn from a larger prospective cohort study conducted between 2013 and 2015. We used survival analysis to estimate the postpartum time periods during which women had a higher risk of sexual intercourse resumption within 6 months after childbirth. Cox proportional hazards regression was used to examine associated factors with sexual intercourse resumption. The cumulative probability of sexual intercourse resumption was lowest (6.2%) in the sub-acute postpartum period (1-45days since delivery) and highest (88.2%) in the delayed postpartum period (151-183days since delivery). Having a live-term baby (adjusted HR 0.52, 95% CI 0.31-0.85, p = 0.01) and an advanced education (adjusted HR 0.63, 95% CI 0.40-0.98, p = 0.04) were associated with a lower risk of sexual intercourse resumption. Desire for another child (adjusted HR 1.36, 95% CI 1.08-1.73, p = 0.01), having a sexual partner (adjusted HR 5.97, 95% CI 3.10-11.47, p < 0.001) and contraceptive use (adjusted HR 2.21, 95% CI 1.65-2.95, p < 0.001) were associated with a greater risk of sexual intercourse resumption. However, only 1 in 4 women who resumed sexual intercourse by the 90th day after childbirth, reported currently using contraception. HIV programs should focus on supporting postnatal women to align the timing of sexual intercourse resumption with their return to contraceptive use. Interventions aimed at improving contraceptive uptake among postnatal WLWH should target the delayed postpartum period.
Highlights
The birth of a child is critical in a woman’s life, more so, among women living with HIV[1, 2]
This study established the timing of sexual intercourse resumption after childbirth and associated factors among women living with HIV in Uganda
The instantenous probability of sexual intercourse resumption was highest in the delayed postpartum period [68.6% (50.6, 89.3)]
Summary
The birth of a child is critical in a woman’s life, more so, among women living with HIV[1, 2]. Some of the factors found to affect the quality of life of postpartum women include depression, lactation problems, urinary complications and difficulties engaging in sexual intercourse after child birth [7]. Several studies have in the recent past explored issues around sexuality during the postnatal period, the majority focussed on women in the general population as opposed to those living with HIV [8,9,10,11].
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