Abstract:

The study objective was to determine the predictors for the use of family planning methods among women living with HIV in two South Eastern States in Nigeria in order to make quality improvement recommendations. This was a descriptive cross sectional study among HIV positive clients attending the HIV clinic in Ebonyi and Enugu State Nigeria. The sample size was 442 clients comprising 142 from Ebonyi and 300 from Enugu. Informed consent was obtained. Data collection was done using interviewer-administered and pretested questionnaires. Quantitative variables were summarized using frequencies, percentages, means and standard deviation. The Chi‑square test was used to evaluate association between categorical variables as appropriate and P-value ≤0.05 was considered statistically significant. Logistic regression analysis was used to assess the relative effect of determinants, adjusting for other predictor variables. Majority (42.3%) of the respondents were aged 30-39years. There were significantly more female (78.4%) respondents compared to males (21.6%). Respondents lived in the urban (47.2%) and sub-urban (48.2%) settings. Most (72.1%) of the respondents, had a tertiary level education and were mostly traders, single and of Christian faith. Less than half (40%) of the respondents had 3-4 babies and had their last babies 5 or more years prior to the study. Occupation and education are strong predictors of contraceptive use among HIV positive clients. Further study will be necessary to determine the behavioral interventions and communication strategy that will further enhance uptake of family planning methods especially among this group in Nigeria.

Keywords: Predictors, Family Planning Use, HIV Positive, South-East Nigeria

References:

[1].Ayesha BMK, Quarraisha AK. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities. Open AIDS J. 2016; 10: 34–48.

[2].Ashimi AO, Amole TG, Ugwa EA, Omole‑Ohonsi A. Awareness, practice and predictors of Family planning by pregnant women attending a tertiary hospital in a semi-rural community of northwest Nigeria. J Basic Clin Reprod Sci 2016; 5:6‑11.

[3].Andia I, Kaida A, Maier M et al., “Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda,” The American Journal of Public Health, vol. 99, no. 2, pp. 340–347, 2009.Chama C, Morrupa J, Gashau W. Sex and reproduction among HIV infected people in Maiduguri, Nigeria. J ObstetGynaecol 2007; 27:812‑5.

[4].Bizuneh G, Solomon S, and Yilma M, “Unmet need and evaluation of program options to meet unmet need for contraception in Ethiopia: further analysis of the 2000 and 2005,” Ethiopia Demographic and Health Survey, 2008, http://www.measuredhs.com/pubs/pdf/FA62/FA62.pdfCredé S, Hoke T, Constant D, Green SM, Moodley J, et al. (2012) Factors impacting knowledge and use of long acting and permanent contraceptive methods by postpartum HIV positive and negative women in Cape Town, South Africa: a cross sectional study. BMC Public Health 12(197).

[5].Dabral S and Malik SI. “Demographic study of Gujjars of Delhi: IV, Kap of family planning,” Journal of Human Ecology, vol. 16, no. 4, pp. 231–237, 2004.

[6].Ezechi OC, Gbajabiamilla TA, Gab-Okafor CV, Oladele DA, Ezeobi PM, Ujah IA. Contraceptive behavior, practices and associated factors among Nigerian women living with human immunodeficiency virus infection. J HIV Hum Reprod 2013; 1:30-5

[7].Federal Ministry of Health. Technical Report: National HIVSero‑prevalence Sentinel Survey; 2010

[8].Hoffman IF, Martinson FEA, Powers KA, Chilongozi DA, Msiska ED, et al. The year-long effect of HIV-positive test results on pregnancy intentions, contraceptive use, and pregnancy incidence among Malawian women. JAIDS. 2008;47(4):477–83.

[9].Melaku YA, Zeleke EG, Kinsman J, Abraha AK. Fertility desire among HIV‑positive women in Tigray region, Ethiopia: Implications for theprovision of reproductive health and prevention of mother‑to‑child HIV transmission services. BMC Womens Health 2014; 14:137.

[10].  Magala I, Onega L, Rose N, et al. Factors influencing contraceptive uptake among sexually active HIV positive clients in TASO Masaka, Uganda. J Public Health Policy Plann 2017;1(2):46-49.

[11]. Polis CB, Gray RH, Lutalo T et al., “Trends and correlates of hormonal contraceptive use among HIV-infected women in Rakai, Uganda, 1994–2006,” Contraception, vol. 83, no. 6, pp. 549–555, 2011.

[12]. Wilcher R, Cates W. Reproductive choices for women with HIV. Bull World Health Organ 2009; 87:833‑9.

[13]. World Health Organization. Global summary of the HIV/AIDS epidemic 2014. http://www.who.int/hiv/data/epi_core_july2015.png?ua=1.

[14]. Yemane Berhane, Haftu Berhe, Gerezgiher Buruh Abera, and Hailemariam Berhe, “Utilization of Modern Contraceptives among HIV Positive Reproductive Age Women in Tigray, Ethiopia: A Cross Sectional Study,” ISRN AIDS, vol. 2013, Article ID 319724, 8 pages, 2013. doi:10.1155/2013/319724.