Unintended Pregnancies in Rural Western Kenya: The Role of HIV Status

Abstract

In a mixed-methods study of Kenyan Luo women living in rural Nyanza Province, where the HIV prevalence is nearly 4 times as high as Kenya overall, approximately 80% (276/349) reported that their pregnancy was unintended. Odds of having an unintended pregnancy were greater for unemployed women (AOR = 2.52, CI = 1.05–6.06) than for women who farmed and greater for women whose poverty level was medium (AOR = 2.54, CI = 1.00–6.41) and high (AOR = 2.80, CI = 1.12–6.98) than for women whose poverty level was low. The odds of having an unintended pregnancy were greater (AOR = 2.04, CI =.96–4.31) among HIV-infected than uninfected-women, although this difference was not statistically significant (p =.062). Qualitative data indicated that community norms surrounding childbirth strongly influence women. Thus, to most effectively reduce unintended pregnancies as well as mother-to-child HIV transmission, public health professionals should focus their efforts on engaging the entire community to lower the economic and cultural/societal barriers to family planning and prevention of mother to child transmission.