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

Abstract

BackgroundThe prevention of unintended pregnancies among HIV positive women is a neglected strategy in the fight against HIV/AIDS. Women who want to avoid unintended pregnancies can do this by using a modern contraceptive method. Contraceptive choice, in particular the use of long acting and permanent methods (LAPMs), is poorly understood among HIV-positive women. This study aimed to compare factors that influence women's choice in contraception and women's knowledge and attitudes towards the IUD and female sterilization by HIV-status in a high HIV prevalence setting, Cape Town, South Africa.MethodsA quantitative cross-sectional survey was conducted using an interviewer-administered questionnaire amongst 265 HIV positive and 273 HIV-negative postpartum women in Cape Town. Contraceptive use, reproductive history and the future fertility intentions of postpartum women were compared using chi-squared tests, Wilcoxon rank-sum and Fisher's exact tests where appropriate. Women's knowledge and attitudes towards long acting and permanent methods as well as factors that influence women's choice in contraception were examined.ResultsThe majority of women reported that their most recent pregnancy was unplanned (61.6% HIV positive and 63.2% HIV negative). Current use of contraception was high with no difference by HIV status (89.8% HIV positive and 89% HIV negative). Most women were using short acting methods, primarily the 3-monthly injectable (Depo Provera). Method convenience and health care provider recommendations were found to most commonly influence method choice. A small percentage of women (6.44%) were using long acting and permanent methods, all of whom were using sterilization; however, it was found that poor knowledge regarding LAPMs is likely to be contributing to the poor uptake of these methods.ConclusionsImproving contraceptive counselling to include LAPM and strengthening services for these methods are warranted in this setting for all women regardless of HIV status. These study results confirm that strategies focusing on increasing users' knowledge about LAPM are needed to encourage uptake of these methods and to meet women's needs for an expanded range of contraceptives which will aid in preventing unintended pregnancies. Given that HIV positive women were found to be more favourable to future use of the IUD it is possible that there may be more uptake of the IUD amongst these women.

Effect of HIV status on fertility desire and knowledge of long-acting reversible contraception of postpartum Malawian women

“…Important misconceptions included the belief that LARC is unsafe in breastfeeding women and in HIV-infected women, similar to beliefs held by HIV-infected and HIV-uninfected women in South Africa (Crede et al, 2012). Overall, postpartum Malawian women knew less about IUC than the implant.…”

“…Survey questions were developed based on previous studies assessing LARC knowledge and interest as well as items from the Malawian Demographic Health Survey (Crede et al, 2012; Natinoal Statistical Office, 2011; Todd et al, 2012). In the survey, we clarified that condoms can be considered a family planning method when used to prevent pregnancy.…”

Determinants of Long-Term Contraceptive Method Use in Madiun, East Java: Application of Social Cognitive Theory

“…Peningkatan akses informasi dapat dilakukan melalui upaya promosi kesehatan yang dilakukan oleh tenaga kesehatan maupun media promosi melalui iklan layanan kesehatan. Upaya dalam penyebaran informasi terhadap penggunaan MKJP dapat meningkatkan penggunaan MKJP melalui perubahan persepsi yang mempengaruhi pengetahuan terhadap MKJP (Credé et al, 2012;Shoupe, 2016). Paparan informasi yang terdapat pada televisi dan radio dapat meningkatkan sesuatu hal yang baru, mengetahui perubahan yang terjadi dalam kondisi sosial serta mendapatkan kesempatan yang lebih baik dan dapat mempengaruhi persepsi dan perilaku seseorang tentang kesehatannya (Melka, et al, 2015;Law et al, 2016) Penulis menyimpulkan bahwa paparan informasi melalui petugas kesehatan maupun layanan kesehatan erat kaitannya dengan perolehan pengetahuan terkait dengan KB dan pengetahuan terhadap MKJP.…”

Sexuality in patients with human immunodeficiency virus at Embhuleni Hospital in Mpumalanga province

“…14,15 In a qualitative study that was carried out in Soweto, 13 many participants agreed that the risks associated with childbearing following HIV diagnosis outweighed the benefits of future fertility. Fears about future pregnancies extended to the fact that the child would be born HIV-positive, that the family would be burdened with more children if HIV shortened the mothers' lives, that pregnancy could have negative consequences on their own health, and that there was a risk of re-infection with a different strain of HIV transmission or partner while trying to conceive.…”