HIV/AIDS and Contraceptive Method Choice: Demographic and Socio-Economic Correlates of Contraceptive Method Choice among HIV-Positive Women Practising Family Planning In Kenya

Abstract

CitationAs the generalized HIV epidemic in specific settings of sub-Saharan Africa continues to evolve, there is need for evidence-based response to address emerging challenges, which include enabling the large number of women living with HIV make informed choices to achieve their reproductive goals. Objectives: This paper seeks to (i) examine the effect of HIV/AIDS on contraceptive method choice among women using contraceptives in Kenya; and (ii) identify correlates of contraceptive method choice among HIV-positive women practising family planning. Material and Methods: We apply multinomial Logistic regression models to a sample of 3190 sexually-active women of reproductive age using contraceptives from the 2003 and 2008 Kenya Demographic and Health Surveys to examine the effect of HIV/AIDS on contraceptive method choice. The analysis of correlates of method choice among HIV-positive women is based on a sample of 255 HIV-positive women using contraceptives and involves bivariate cross-tabulations with Chi-Square tests. Result: Overall association between HIV status and contraceptive method choice is consistent with expected patterns, with women who are HIV-positive being more than twice as likely to use condoms rather than hormonal contraceptives, compared to their counterparts of similar characteristics who are HIV-negative (p<0.05). Among women infected with HIV, those who were previously tested for HIV were more likely to use condoms and less likely to use hormonal methods (p<0.05) than those who had never been tested. The higher use of condoms by HIV-positive women is only evident among those who had previously been tested for HIV. Significant correlates of contraceptive method choice among HIV-positive women include parity, marital status, age group, education and ethnicity. Overall trends suggest a notable shift from use of hormonal methods to condoms by HIV-positive women, but predominant use of hormonal methods (60%) and low use of condoms (23%) by HIV-positive young women aged 15-24 practising family planning is of potential concern. Conclusion: The findings have important implications for family planning policies/programs targeting young women living with HIV and underscore the need to intensify efforts towards improved HIV testing coverage to enable HIV-positive women make informed reproductive choices.

HIV and Unintended Fertility in Sub-Saharan Africa: Multilevel Predictors of Mistimed and Unwanted Fertility Among HIV-Positive Women

“…Besides, it has been observed that even where no evidence of a significant relationship between HIV status and unintended fertility is apparent, HIV-positive women are likely to make greater efforts than HIV-negative women to prevent unintended fertility, but with less success (Bankole et al 2014). HIV-positive women may be predisposed to a higher risk of unintended fertility due to disproportionate reliance on less effective contraceptive methods such as condoms or periodic abstinence (Wall, et al, 2013;Schaan et al, 2014;Magadi, 2016), with low practice of dual protection (Berer 2006).…”