HIV-positive Women Of Reproductive Age Research Articles

Knowledge, attitude, practices and associated factors of family planning among women living with hiv at the university of Gondar specialized hospital: a cross sectional study

IntroductionHIV/AIDS poses a significant health challenge in sub-Saharan African countries, with a disproportionate impact on women of reproductive age. The disparities in knowledge, attitudes, and practices related to family planning among women living with HIV can be intricate and multi-faceted. This study aimed to assess the knowledge, attitude, practice, and associated factors regarding family planning among the women living with HIV at the University of Gondar specialized hospital, Gondar, Ethiopia.MethodA cross-sectional study was carried out at the University of Gondar Teaching Referral Hospital, focusing on HIV-positive women of reproductive age who visited the ART unit from July 8–28, 2022. Data collection involved the use of pre-tested, structured questionnaires administered through interviews. The gathered data were entered into the electronic Kobo Collect platform and subsequently exported for analysis using SPSS version 26. Descriptive summaries, including frequencies, means, and percentages, were presented through tables and figures. Logistic regression was employed to identify potential predictors, presenting adjusted odds ratios with a 95% confidence interval and a significance level set at a P-value of 0.05.ResultsA total of 328 study participants were included. About 93% of the study population had good knowledge about modern contraceptives, and about 94% of the study population had good knowledge about safer conception. Only 30.2% of the study population had knowledge of the dual contraceptive method. The attitude and practice of women towards family planning (FP) were 71.0% and 55.8%, respectively. The study revealed that the most commonly employed contraceptive method was injectable contraceptives, constituting 34.2% of usage. Having one and a greater number of children (AOR = 2.25, 95% CI: 1.10, 4.49), having discussions on fertility plans with healthcare providers (AOR = 2.20, 95% CI: 1.02, 4.761), and having good family planning practices (AOR = 2.15, 95% CI: 1.19, 3.87) were significantly associated with the attitude toward family planning. Married women (AOR = 1.88, 95% CI = 1.11, 3.1), able to read and write (AOR = 2.12, 95% CI:1.04,4.32), college and above educational level (AOR = 4.51, 95% CI:1.93,10.87), had discussion on fertility plan with healthcare providers (AOR = 5.09, 95% CI: 1.96, 13.24), knowledge about dual method (AOR = 1.95, CI: 1.08, 3.50), and knowledge about modern contraceptive methods (AOR = 7.24, 95% CI: 1.56, 33.58) were significantly associated with good practice of family planning.ConclusionWomen living with HIV exhibited notably high levels of knowledge regarding modern contraceptive methods and safer conception. The knowledge of the dual method was low. More than half of the study population had good practice in family planning. More than two-thirds of HIV-positive reproductive-age women had a good attitude about family planning. Having one or a greater number of children, having a discussion on a fertility plan with a healthcare provider, and having a good practice of family planning were significantly associated with a good attitude toward family planning. Married women, education status, discussions on fertility plans with healthcare providers, knowledge about dual methods, and knowledge about modern contraceptive methods were significantly associated with good family planning practices. The stakeholders should design interventions based on the aforementioned factors to improve the attitude and practice of family planning.

Determinants of unmet need for family planning among HIV-positive women of reproductive age in a treatment and care center Jos, Northcentral Nigeria

Introduction: About half of Nigeria’s population living with HIV are women. Therefore, the use of contraceptives is useful for HIV prevention. The aim of this study was to assess the unmet need for family planning and its associated factors among HIV-positive women of reproductive age in Jos, North-central. Nigeria.Method: This facility-based cross-sectional study was conducted among 335 HIV positive women of reproductive age attending the (APIN) Public Health Initiative Centre of the Jos University Teaching Hospital in Plateau State. A systematic sampling technique was used to select participants. Pre-tested intervieweradministered questionnaires were used for data collection and statistical analysis done using the SPSS version 23 software package. A logistic regression model was used to identify determinants of unmet needs for family planning. Ethical approval was obtained for the study.Results: The mean age of the respondents was 37.44 ± 6.40 years. Unmet need for family planning was 25.4% and the commonest reasons cited include partner opposition and fear of side effects. Marital status, duration of HIV diagnosis, duration on HAART, use of condom during the last sexual act, partner/husband support, and desire for more children were found to be associated with unmet need for family planning. Predictors of unmet need for family planning were marital status (AOR=0.15, P-value-0.030), duration of HIV diagnosis (AOR=5.09, P-value-0.005), duration on HAARTs (AOR=2.64, P-value-0.03) and desire for more children (AOR=0.42, P-value-0.001).Conclusion: HIV-positive women of reproductive age in Jos have high unmet needs for family planning and will benefit from early reproductive health education which includes couple counseling on contraceptive use.

Rural-urban disparities in nutritional status among women in Ethiopia based on HIV serostatus: a cross-sectional study using demographic and health survey data

BackgroundEthiopia is one of the sub-Saharan African countries most affected by the human immunodeficiency virus (HIV) epidemic and also by severe undernutrition, which is particularly prevalent among women. HIV infection, reproductive biology, and their role in society increase the vulnerability of women to malnutrition. Various factors including urbanization could cause differences in the nutritional status of rural and urban residents. In this study, we aimed to assess rural-urban disparities in nutritional status among women of reproductive age based on HIV serostatus in Ethiopia.MethodData from the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 were used. Among 15,683 women included in the survey, 8822 non-pregnant women aged 15–49 years, including those who gave birth two months before the DHS survey were included in this study. Multinomial logistic regression was used to determine the relative risk ratios (RRR) for the associations between study variables.ResultsGenerally, the prevalence of underweight among women of reproductive age was higher in rural residents (28.9%) than in urban residents (12.3%) in Ethiopia. Being overweight was more prevalent among urban women than rural women, (35.1% vs. 4.8%). About 32% of HIV-positive women were underweight in both rural and urban areas. About 29% of HIV-positive urban women were overweight compared to 3.4% of HIV-positive rural women. Among urban residents, HIV-positive women were about 4 times more likely to be underweight than their HIV-negative counterparts, RRR 3.8 (95% CI: 1.58, 9.26). However, there was no significant difference in nutritional status between HIV-positive and HIV-negative women living in rural areas. Anemic women were more likely to be underweight while, wealthy women were less likely to be underweight in both rural and urban areas. Women aged 25–49 years were generally more likely to be overweight/obese and less likely to be underweight compared to younger women aged le 24years.ConclusionMalnutrition was more prevalent among HIV-positive women living in urban Ethiopia. Targeted nutritional interventions for HIV-positive women of reproductive age living in urban areas could be considered. Furthermore, efforts should be made to improve the nutritional status of women of reproductive age across the country.

The Effectiveness of nurse-led PMTCT health education on self-stigma reduction among HIV-positive women in Mombasa County, Kenya

BACKGROUND 
 Stigma compromises the quality of life of people living with HIV/AIDS. There is a critical knowledge gap on how to combat self-stigma among HIV-positives. the study assessed the effectiveness of nurse-led PMTCT health education on self-stigma reduction among HIV-positive women attending PMTCT antenatal clinics in Mombasa County, Kenya. 
 METHODOLOGY 
 The study used a two-group, quasi-experimental research design. All pregnant HIV-positive women of reproductive age (18-49) who attended PMTCT prenatal clinics at the selected Mombasa County healthcare facilities were included in the study. A nurse-led health education program on PMTCT was provided at the intervention location but not at the control site. The mean difference in the proportion of mothers who reported self-stigma between the intervention and control groups was computed using a chi-square statistic. To assess the effectiveness of nurse-led PMTCT health education intervention, the difference in difference (DiD) was conducted. 
 RESULT 
 Chi-square statistics indicated that there were significantly (χ2=151.096, df=1, p<0.001) more HIV-positive women with low self-stigma in the intervention group compared to the control group at the end-line survey. Nurse-led health education on PMTCT reduced the proportion of self-stigma in HIV-positive women from 62.1% to 10.6%. It thus reduced the proportion of self-stigma in HIV-positive women significantly by 82.6%. 
 CONCLUSION 
 Nurse-led PMTCT health education should be integrated with other interventional strategies aimed at reducing self-stigma among HIV-positive women attending PMTCT antenatal clinics

Determinants of long act reversible contraceptive utilization among HIV positive reproductive age women attending ART clinic in South West Ethiopia

BackgroundIdentifying the determinants of long-acting contraceptive utilization and managing the sexual and reproductive health of HIV-infected women is critical to reducing HIV transmission and maternal mortality. However, the determinants of long-acting contraceptive utilization have not been well understood in resource-limited settings like Ethiopia. The aim of this study was to identify determinants of long-acting reversible contraceptive utilization among HIV-positive women on ART in southwest Ethiopia.MethodsA facility-based, unmatched case control study was conducted from July 24 to August 28, 2021, in south-west Ethiopia. The study participants were HIV positive women, with a sample size of 109 cases and controls. An interviewer administered a questionnaire, and a check list was used for data collection. A systemic random sampling technique was used to collect data from cases and controls. Bivariate and multivariable logistic regressions were employed to determine the determinants of LARC utilization among HIV-positive women. To demonstrate the strength of the determinant, the odds ratio was calculated with 95% confidence intervals, and a P-value less than 0.05 was used to declare statistical significance.ResultA total of 324 women (108 cases and 216 controls) of reproductive age who were HIV positive were interviewed, with a response rate of 99.0%. urban residence (AOR = 2.67, 95%CI: 1.23- 5.77), having formal education (AOR = 2.93, 95% CI:1.36, 6.34), being counseled by health care provider (AOR = 5.42,95% CI: 2.67–11.03), no future fertility intention (AOR = 2.87, 95% CI:1.44–5.70), having CD4 count less than 500 cell/mm3 (AOR = 4.18,95% CI:2.12–8.23), having information of HIV transmission from mother to child (AOR = 3.65,95% CI:1.49–8.95),not using condom during sexual intercourse (AOR = 4.86,95% CI:2.46–9.62),,having knowledge towards LARC (AOR = 2.38,95% CI:1.24–4.58) and attitude towards LARC (AOR = 6.41,95%CI:3.16–13.0) were independent determinants of LARC utilization among HIV positive women.Conclusion and recommendationWomen being counseled by a health care provider, having no future fertility intention, and having a CD4 count less than 500 cells/mm3 were found to be determinants of long-acting contraceptive method utilization among HIV-positive reproductive-age women. Also, our study supports the WHO Strategic Concepts for Improving the Links between Family Planning and HIV/AIDS Policy, Programs, and Services. It is recommended that Health care providers should use these factors as base line during family planning counseling and service delivery.

Factors associated with uptake of contraceptives among HIV positive women on dolutegravir based anti-retroviral treatment-a cross sectional survey in urban Uganda

BackgroundIn May 2018, following the preliminary results of a study in Botswana that reported congenital anomalies in babies born to HIV-positive women taking dolutegravir drug, the WHO issued a teratogenicity alert. However, there are scarce data on the impact of this guidance on contraceptive uptake among women taking dolutegravir. We assessed the uptake of contraceptives in HIV-positive women of reproductive age on dolutegravir regimens.MethodsWe conducted a cross-sectional survey from April 2019 to July 2019 in five government health facilities in central Uganda, where dolutegravir-based regimens were offered as the preferred first-line antiretroviral treatment. We randomly selected 359 non-pregnant women aged 15–49 years taking dolutegravir-based regimens and interviewed them using semi-structured interviewer-administered questionnaires. We collected data on demographics, contraceptive use, individual, social, and health system factors. We described patients’ characteristics using descriptive statistics and assessed factors associated with contraceptive uptake using a modified Poisson regression model.ResultsA total of 359 women were included in the study. The mean age was 37 years (standard deviation = 6.8) and overall contraceptive uptake was 38.4%. The most utilized method was injectable method at 58.4% followed by condoms (15%), intrauterine device (10.7%), pills (6.4%), implants (5.4%), and sterilization (0.7%). Predictors for contraceptive uptake were parity of 3–4 children (Adjusted Prevalence Ratio (APR) = 1.48, 95% confidence interval (CI): 1.14, 1.92) in reference to those with 1–2 children. There was reduced contraceptive uptake in women of the age range 40–49 years (APR = 0.45, CI: 0.21–0.94) compared to those aged 15–24 years. Unemployed women were less likely to use contraceptives (APR: 0.6, CI: 0.42- 0.94) than the formally employed. Contraceptive uptake was lower among women who did not discuss family planning with their partners (APR = 0.39, CI: 0.29–0.52) than those who discussed family planning with their partners and women who did not receive family planning counseling (APR = 0.56, CI: 0.34–0.92) than those who received family planning counselling.ConclusionWe observed a low-level uptake of contraceptives, with injectables as the most used method. Family planning counseling and partner discussion on family planning were associated with contraceptive uptake among the women who used dolutegravir-based regimens. There is a need for more strategies to integrate FP services and increase male involvement in HIV care programs.

Consistent condom use and associated factors among HIV positive women of reproductive age on anti-retroviral treatment in Ogun state, Nigeria

consistent condom use remains an integral and essential part of comprehensive Human Immunodeficiency Virus (HIV) prevention and care programme. This study assessed consistent use of condom among HIV-positive women of reproductive age on antiretroviral treatment and its associated factors. a cross-sectional survey of 360 women living with HIV (WLHIV) receiving treatment in four APIN Public Health Initiatives, Nigeria supported President's Emergency Plan for AIDS Relief (PEPFAR) comprehensive Antiretroviral Therapy (ART) sites in Ogun State was conducted from October 2018 to March 2019. Information were collected on consistent condom use among respondents and their associated factors using a pre-tested questionnaire. Data were analysed using SPSS IBM version, with statistical significance set at 0.05. the mean age of the women was 38.1 ± 5.8 years. About two-fifth (39.4%) of the respondents reported consistent use of condom. Of the 142 respondents who reported inconsistent use of condom, 51.6% and 37.5% mentioned sexual displeasure and partner's disagreement respectively as reasons for inconsistent use. Factors associated with consistent condom use were marital status (p < 0.001), respondent's occupation (p = 0.040), partner's occupation (p = 0.012) and partner's HIV status (p = 0.045). Respondents with HIV negative partners were 1.8 times more likely to use condom consistently compared to those with HIV positive partners (AOR = 1.826, CI = 1.018 - 3.274). this study concludes that there is poor consistent condom use among WLHIV in Ogun State. The rate is worse among the sero-concordant partners than the sero-discordant partners. More needs to be done through behaviour change communication aimed at improving consistent condom use among HIV clients.

Prevalence and factors associated with fertility desire among HIV-positive women in Rwanda in the context of improved life expectancy

BackgroundThe knowledge of the key factors associated with fertility desire among people living with HIV/AIDS is crucial for the efficient planning of maternal and child health care programs. Fertility desire has generally increased among women of reproductive age in Rwanda. However, its level and determinants among women living with HIV/AIDS (WLHA) are currently not well known in the context of Rwanda. The present study aimed to fill in this knowledge gap.MethodsData were extracted from the 2015 Rwanda demographic and health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable logistic regression analyses were conducted in order to identify the most influential factors.ResultsThe prevalence of desire to have another child in HIV-positive women was found to be as high as 40.7%. Multivariable logistic regression analyses showed that the woman’s age of 35–49 years (AOR = 0.051, 95% CI: 0.013–0.204), woman’s parity of 3 children or above (AOR = 0.177, 95% CI: 0.037–0.837), being employed (AOR = 0.298, 95% CI: 0.113–0.782) and currently using contraceptives (AOR = 0.146; 95% CI: 0.057–0.375) were significantly associated with low odds of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, or who were unemployed or who were not using any contraceptive were significantly associated with greater odds of desire to have another child than did other HIV- positive women. A woman whose partner's desire for children is different from hers was associated with about four times higher odds (AOR = 3.752; 95% CI: 1.203–11.702) of desire for more children than women who desire the same as their partners.ConclusionFertility desire in WLHA is currently high in Rwanda. It is significantly influenced by demographic and socioeconomic factors. The Rwanda’s health care system should be prepared to intensify the required services for the prevention of the vertical transmission of HIV, the delivery of maternal and child health care services, and the support to WLHA in planning their fertility. Interventions should target low-parity young women, with a particular focus on meeting their contraceptive needs.

Unmet need for modern contraceptives and associated factors among HIV positive reproductive age women attending at ART clinic in government hospitals Addis Ababa, Ethiopia

Introduction: Every year in Ethiopia, 84,189 pregnancies occur among Human Immune Virus positive women and around 14,140 HIV-positive babies are born. Unmet need for contraceptives is a major cause of unintended pregnancy among HIV-positive women. However, the magnitude of unmet needs among HIV-positive reproductive-age women is not well known in Addis Ababa. The objective of this study was to determine the unmet need for modern contraceptives and its associated factors among HIV-positive reproductive-age women attending antiretroviral therapy clinics at government hospitals in Addis Ababa, Ethiopia.

Determinants of long acting contraceptive utilization among HIV positive reproductive age women attending care at ART clinics of public health facilities in Arba Minch town, Southern Ethiopia, 2019: a case control study

BackgroundLong acting and permanent contraceptive methods by far are the most effective, very safe and convenient methods than short acting contraceptive methods. But in less developed countries, use of long acting reversible contraceptive or permanent methods (LARCs/PMs) is very low. Therefore the aim of this study was to identify determinants of long acting contraceptive method utilization among HIV positive reproductive age women.MethodsAn institutional based case control study was conducted among random sample of 354 HIV positive reproductive age women (total of 97.8% response rate) at Anti-Retroviral Therapy clinics from February 20 to March 20, 2019. Case to control ratio was 1:2. A structured questionnaire and information recorded from ART card review were used to collect the data. Each variable was entered in Bivariate analysis with dependent variables and those variables with P-value of ≤ 0.25 were included in the Multivariate analysis. Significance was determined at the level of P-value < 0.05 with 95% CI of AOR.ResultsA total of 354 (33.3% cases and 66.7% controls) HIV positive reproductive age women were interviewed with response rate of 97.8%. The study revealed being in age group of 39 and above [AOR = 0.17, 95% CI (0.06, 0.48)], being divorced/separated and widowed [AOR = 0.05, 95% CI (0.003, 0.61)], having supportive opinion and strongly supportive opinion regarding family planning service availability in ART clinic [AOR = 5.01, 95% CI (1.79, 14.07)], [AOR = 7.81, 95% CI (2.54, 24.01)] and having no future fertility intention [AOR = 7.03, 95% CI (2.73, 18.06)] were statistically significant determinants for long acting contraceptive method utilization.ConclusionWoman in age group of 39 and above, having no future fertility intention and being divorced/separated and widowed was found to be determinants of long acting contraceptive method utilization among HIV positive reproductive age women. In addition our study support the WHO Strategic Considerations for Strengthening the Linkages between Family Planning and HIV/AIDS Policies, Programs, and Services.

Reliability, Validity and Measurement Invariance of the WHO’s Quality of Life Scale among Women of Reproductive Age Living with HIV in Ethiopia - a Quasi-Experimental Study

Despite its widespread global adoption and use, studies have not examined measurement invariance of the 31-question World Health Organization Quality of Life–HIV BREF scale among HIV/AIDS patients. The current study seeks to (a) evaluate the scale’s internal consistency reliability, and concurrent validity, and (b) test if the same latent construct of quality of life was consistently measured at two time-points, for a sample of HIV-positive women from two sites in Addis Ababa, Ethiopia. The study used data from two cross-sectional interviews with 926 HIV-positive women of reproductive age who participated in a quasi-experimental study. All participants were receiving antiretroviral therapy and related treatment support services from 51 service providers in two non-contiguous sub-cities. We used One-Way ANOVA, chi square test and Kruskal Wallis test to compare demographic characteristics and quality of life scores of study participants. Further, we used Cronbach’s coefficient alpha (α) to assess internal consistency reliability and Pearson product-moment correlation (r) to assess concurrent validity. Finally, multiple-group confirmatory factor analysis with maximum likelihood estimation was used to assess measurement invariance of the quality of life scale. Findings suggest that the WHOQOL-HIV BREF exhibited acceptable psychometric properties. There was evidence for strong internal consistency reliability demonstrated by Cronbach’s α >0.80 and coefficient ω >0.80. The scale’s six domains also exhibited good concurrent validity, with coefficient r = 0.63–0.82. In measurement invariance analysis, configural invariance was found for the scale’s six domains, suggesting measurement noninvariance for factor loadings, item intercepts and factor variances when comparing QOL among participants in the two sites at baseline and follow-up. Our findings suggest that the WHOQOL-HIV BREF has internal consistency reliability and concurrent validity in this study sample. The differences in the levels of observed responses for QOL across intervention and non-intervention groups at baseline and follow-up suggest participants had dissimilar understanding, interpretation, and responses to the scale’s items, which may have resulted from significant measurement, cultural, and developmental differences between study groups. The WHOQOL-HIV BREF exhibited internal consistency reliability, concurrent validity and configural invariance. However, strong invariance was not achieved, making it difficult to compare levels of QOL between groups in this study sample.

Современные представления об особенностях микробиоценоза влагалища у ВИЧ-позитивных женщин фертильного возраста

Современные представления об особенностях микробиоценоза влагалища у ВИЧ-позитивных женщин фертильного возраста

Patterns and predictors of contraceptive usage among HIV-positive women of reproductive age attending PMTCT/ART clinics in Ogbomoso, Nigeria

Objective: the objective of the study is to assess the patterns and predictors of contraceptive usage among HIV positive women of reproductive age attending PMTCT/ART clinics in Ogbomoso, Oyo state, Nigeria. Methods: it was a cross-sectional descriptive cross-sectional study conducted among HIV positive women of reproductive age group selected using multi-stage sampling technique. Data was collected using a pre-tested semi-structured interviewer administered questionnaire and analyzed using Statistical Package for Social Sciences. The questions about knowledge of and attitude towards contraception were scored, and categorized as good or poor knowledge, favourable or unfavourable attitude. Univariate, bivariate, and multivariate analyses assessed predictors of contraceptive usage. A bivariate logistic regression model which used p<0.05 as the entry criterion, was generated to calculate the odds ratios and 95% confidence intervals respectively. Results: age ranges from 16 to 48 years with mean age 31.8 + 7.8 years. Majority are within age range of 25-35 years 110 (40.7%), Christians 178 (65.9%), Yoruba 235 (87%), educated 246 (91.1%) and within monogamous settings 179 (66.3%). About half of the respondents 158 (58.5%) had favorable attitude and adequate knowledge respectively. There is a significant difference (p<0.05) between education and categorized knowledge on usage of contraception. Those who have adequate knowledge are twice more likely to use contraception compared to those with inadequate knowledge. Those who are less educated are 3.3 times less likely to use contraception compared to those that are educated. Conclusion: The findings in this study showed that about half of the respondents had high knowledge and favorable attitude on family planning. Keywords: reproduction, education, health, virus, knowledge

Natural History of Cervical Intraepithelial Neoplasia-2 in HIV-Positive Women of Reproductive Age.

To evaluate the natural history of treated and untreated cervical intraepithelial neoplasia-2 (CIN2) among HIV-positive women. Participants were women enrolled in the Women's Interagency HIV Study between 1994 and 2013. One hundred four HIV-positive women diagnosed with CIN2 before age 46 were selected, contributing 2076 visits over a median of 10 years (interquartile range 5-16). The outcome of interest was biopsy-confirmed CIN2 progression, defined as CIN3 or invasive cervical cancer. CIN2 treatment was abstracted from medical records. Most women were African American (53%), current smokers (53%), and had a median age of 33 years at CIN2 diagnosis. Among the 104 HIV-positive women, 62 (59.6%) did not receive CIN2 treatment. Twelve HIV-positive women (11.5%) showed CIN2 progression to CIN3; none were diagnosed with cervical cancer. There was no difference in the median time to progression between CIN2-treated and CIN2-untreated HIV-positive women (2.9 vs. 2.7 years, P = 0.41). CIN2 treatment was not associated with CIN2 progression in multivariate analysis (adjusted hazard ratio 1.82; 95% confidence interval: 0.54 to 7.11), adjusting for combination antiretroviral therapy and CD4 T-cell count. In HIV-positive women, each increase of 100 CD4 T cells was associated with a 33% decrease in CIN2 progression (adjusted hazard ratio 0.67; 95% confidence interval: 0.47 to 0.88), adjusting for CIN2 treatment and combination antiretroviral therapy. CIN2 progression is uncommon in this population, regardless of CIN2 treatment. Additional studies are needed to identify factors to differentiate women at highest risk of CIN2 progression.

181 - The Correlation between Antioxidant Deficiency and Reproductive Disorders in Women with HIV-infection

Background An evaluation of oxidative stress and antioxidant defense activity parameters in patients with HIV-infection is of great importance, especially for HIV-positive women of reproductive age planning to have children. The aim of this study was to identify antioxidant deficiency and frequency of reproductive disorders correlation in women with HIV-infection. Methods 53 women with HIV infection (mean age - 31.13 ± 4.49 years) were included in the investigations. They were divided into four groups depending on vitamins in blood plasma content (36 women - α-tocopherol level less than 12 μmol/L (group 1); 17 women α-tocopherol level in the range 12-24 μmol/L (group 2); 35 women with retinol level less than 1.05 μmol/L (group 3) and 18 women – retinol level in the range 1.05-2.8 μmol/L (group 4). Spectrophotometric and fluorometric methods used. Results Our study proved that women with HIV and α-tocopherol deficiency have higher level of the reproductive system disorders (incidence of menstrual disorders (63%), infertility (36.1%), and a high percentage of failure of the luteal phase) than in the group with normal vitamin content. Increased levels of primary lipid peroxidation products - diene conjugates (1.8 ± 0.9 μmol/L in group 1 patients than those in group 2 (1.3 ± 0.7 μmol/L) (p=0.043), with the absence of significant differences in the content of the thiobarbituric acid reactants in this group were registered. Conclusion The results obtained showed a close correlation of α-tocopherol deficiency and disorders of the reproductive system in women with HIV-infection. It is a significant reason to recommend including of antioxidant drugs in HIV-women patients of complex pathogenetic therapy to regulate adequately their reproductive function and possibly to preserve reproductive ability in these women.

Modern Contraceptive Utilization and Associated Factors among HIV Positive Women on Antiretroviral Therapy in Mizan-Tepi Teaching and Referral Hospital, South-West Ethiopia

Background: Women living with human immunodeficiency virus encounter unintended pregnancy with related risk of mother to child transmission of HIV. Unintended pregnancy among these peoples is associated with inconsistence use of contraceptives. The aim of this study is to assess the prevalence of modern contraceptive utilization and associated factors in the Mizan-Tepi teaching and referral hospital. Methods: Hospital based cross-sectional study was conducted on 382 HIV positive reproductive age women who were on antiretroviral therapy. Data was gathered using pretested structured questionnaire in exit interview. Data was entered using Epidata version 3.1 and exported to SPSS version 21.0 for further analysis. Binary and multivariable analyses were done using SPSS. Results: Majority (98.2%) of women ever heard at least one type of modern contraceptives. However, only 64.1% of them were using modern contraceptives. Injectables (64.9%) and condoms (31.4%) were the most commonly used contraceptives whereas intrauterine devices and implants were used by only 2.4% and 9.8% of the participants respectively. Women whose age ≥ 35 years old (AOR=0.30; 95% CI: 0.09, 0.96), Muslims (AOR=0.34; 95% CI: 0.17, 0.67), widowed/ separated (AOR=0.21; 95% CI: 0.10, 0.45), monthly income ≥ 1500 birr (AOR=0.29; 95% CI 0.13, 0.69) and not having discussion with partner (AOR=0.18; 95% CI 0.07, 0.47) were less likely to use modern contraceptives. Whereas, women whose partner educational status secondary and above (AOR=2.78; 95% CI 1.22, 6.36) were more likely to use modern contraceptives. Conclusion: Modern contraceptive utilization is suboptimal. But, utilization of long acting contraceptives was found to be very low. Partner level of education and open discussion with partner were positively associated with contraceptive use. However, old age, being Muslim and being widowed/separated were negatively associated with current contraceptive use. Therefore, behavioral education and communication targeted on improving contraceptive use among HIV positive women need to address these factors.

HIV status, fertility intentions, and contraception in the era of expanded access to antiretroviral therapy: A case study of rural Mozambique

ABSTRACTProvision of effective contraception to HIV-positive women of reproductive age is critical to effective management of HIV infection and prevention of both vertical and horizontal HIV transmission in developing countries. This exploratory retrospective study examines contraceptive use during the prolonged post-partum period in a sample of 285 HIV-positive and HIV-negative women who gave birth at four rural maternity clinics in a high HIV-prevalence region in Mozambique. Multivariate analyses show no significant variations by HIV status in contraceptive timing (mean time to first contraceptive use of 7.1 months) or prevalence (31% at time of survey) but detect a moderating effect of fertility intentions: while HIV status makes no difference for women wishing to stop childbearing, among women who want to continue having children, or are unsure about their reproductive plans, HIV-positive status is associated with higher likelihood of contraceptive use. Regardless of HIV status, virtually no condom use is reported. These results are situated within the context of a rapidly widening access to post-partum antiretroviral therapy in the study site and similar sub-Saharan settings.

Utilization of contraception among sexually active HIV positive women attending art clinic in University of Gondar Hospital: a hospital based cross-sectional study.

BackgroundContraception helps to prevent unplanned pregnancies among human immune virus positive women. The contraceptive utilization status and associated factors were not well addressed in the study area. Therefore, this study aimed to assess utilization of contraceptives and associated factors among human immune virus positive reproductive age group women appearing at anti-retroviral therapy clinic at the University of Gondar Hospital, North West Ethiopia.MethodAn institution based cross-sectional study was conducted among 397 systematically selected HIV positive reproductive age women who visited ART unit of the University of Gondar teaching referral hospital from January 8-20, 2014. The data were collected using pre tested and structured questionnaires through face-to-face interviews. The data were entered into Epi-Info version 3.5, and cleaned and analyzed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95 % confidence interval and P-value of 0.05.ResultsThe study revealed that the overall utilization of any type of contraception was 50 %. Of them, 4.1 % got contraception from anti-retroviral therapy unit. Fear of side effects was the most common (42 %) reason for not using contraception. Women who attended secondary education, married and who had 4-6 children were more likely to use contraception than their counterparts were; (AOR: 5.63; 95 % CI: 1.74–18.21), (AOR: 8.07; 95 % CI: 3.10–20.99) and (AOR: 3.61; 95 % CI: 1.16–11.26) respectively. However, Women between 35–49 years, had no intention to have another child and discordant couples were 83 %, 76 % and 65 % less likely to use contraception respectively than their counterparts.ConclusionsThe results of this study revealed that the utilization of contraception was low. Women between 35–49 years, those who had no intention to have another child and whose partner was HIV sero-negative and fear of side effect of the contraception played an important role for not using contraception. Therefore, there is a need to give attention about integration of family planning service with HIV care and support service.

Reproductive desires and intentions of HIV-positive women of reproductive age attending the adult HIV clinic at the Jos University Teaching Hospital, Jos, Nigeria

Background: The advent of highly active antiretroviral therapy (HAART) in the medical management of human immunodeficiency virus (HIV) infection has modified the natural history of HIV, resulting in improvements in the quality of life and life expectancy of women living with HIV. Consequently, many HIV-positive women of reproductive age are considering the possibility of having their own biological offspring. Materials and Methods: This was a cross-sectional study conducted among HIV-positive women of reproductive age attending the adult HIV clinic at the Jos University Teaching Hospital, Jos, Nigeria. Equal numbers of HIV-positive women of reproductive age in serodiscordant and seroconcordant relationships, who met the selection criteria, were recruited using convenience sampling technique. Data were collected using a pretested questionnaire in a face-to-face interview, and were analyzed using the Statistical Package for the Social Sciences statistical software (version 17) to determine their reproductive intentions using Chi-square and t-test. Multiple logistic regressions were used to determine the relationship between independent variables and the intentions of respondents to have children. Results: A total of 500 women were recruited for the study (250 in serodiscordant relationship and 250 in seroconcordant relationship). The overall reproductive desires and intentions were 60% and 56.4%, respectively. The reproductive intentions among those in serodiscordant and seroconcordant relationships were 63.2% and 49.6%, respectively. The difference was statistically significant. Conclusion: The reproductive intentions among the HIV- positive women in this study were high, the intentions being much higher among those in serodiscordant relationship. With a compelling intention to exercise their parenthood, there is a need for us to provide appropriate reproductive and sexual health services and support for all HIV-positive women of reproductive age.

Modern Family Planning Utilization and Associated Factors among HIV Positive Reproductive Age Women in Debre Markos Referral Hospital Northwest Ethiopia, 2014 G.C.

The study was conducted to find out modern family planning utilization and associated factor among HIV positive reproductive age women attending anti retroviral treatment care in Debremarkos referral hospital, in Ethiopia. Institution based cross-sectional study was carried out. Three hundred thirty five HIV positive reproductive age women were selected using systematic random sampling methods. Data were collected and analyzed. About 47.9% HIV positive reproductive age women are currently using modern family planning methods. Level of education has significant effect on utilization of modern family planning methods. Women with primary education and secondary education and above are utilizing modern family planning methods 2.71 times and 6.91 times more from non educated women, respectively. Number of children has also effect in utilization of modern family planning methods. Those who have one child and two and more children are utilizing modern family planning methods 5.31 and 11.66 times more than those who do not have children, respectively. Utilization of modern family planning methods was low and the most commonly used methods were condom and inject able contraceptives. In order to enhance utilization of modern family planning methods for HIV positive women, family planning services must be integrated with anti retro viral treatment care and support service sites and women’s educational status must be improved.