Abstract
BackgroundPreventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use.MethodsA facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use.ResultsA total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24–0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10–0.37) and women in the age group of 25–34 years (AOR 0.42, 95% CI = 0.20–0.88) and 35–49 years (AOR 0.41, 95% CI = 0.17–0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15–24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26–3.57) were more likely to use modern family planning methods compared with women with lower incomes.ConclusionThis study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.
Highlights
Preventing unintended pregnancies among Human Immunodeficiency Virus (HIV) positive women is one component of HIV prevention strategies
This study aimed to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use
The sample was determined based on prevalence of unmet need for family planning which is 18.8% among women living with HIV [18] which is a proxy indicator to see family planning and HIV integration status, 5% margin of error, 95% confidence interval and design effect of 2, and 10% nonresponse rate
Summary
Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. Programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. 222 million women either want to delay or avoid their pregnancy but they are not using modern contraceptive methods. This includes women who are Zewdie et al BMC Pregnancy and Childbirth (2020) 20:145. Without appropriate prevention of mother to child transmission (PMTCT) interventions, about 50% of those infants born with HIV will die before their second birthdays [5,6,7]. Preventing unintended pregnancies among women living with or at-risk of contracting HIV is a key component of the global HIV prevention strategy [8]. Planning can help achieve HIV prevention goals and improve maternal and child health outcomes [2]
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