Scale up use of family planning services to prevent maternal transmission of HIV among discordant couples: a cross-sectional study within a resource-limited setting

Abstract

BackgroundIntegration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services.MethodsWe conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon. First, structured questionnaires related to family planning use, PMTCT services use, and infection risk of the sexual partner were administered to the first trimester pregnant women who were HIV infected and living with uninfected partners. Second, 2 weeks before the delivery date, the women were interviewed according to the prior counseling interventions received, in order to assess their behavior on FPS, antiretroviral therapy (ART) use, delivery option, and infant nourishment to be adopted. P-values below 0.05 were considered statistically significant in the statistical analyses.ResultsOf 94 HIV-infected women, 69% were stable couples. Only 13% of women had attended FPS before conception. Although the vast majority were knowledgeable about modern and traditional contraception methods, only 19% had experienced effective contraceptive methods. However, 66% preferred condom use, 45% having three children still expressed a desire to conceive, while 44% reported abortions, 65% had tried to avoid the current pregnancy, and 12% of women were ART naïve. Several predictors such as education, abortion rate, unplanned pregnancies, and partners’ decision were associated with the nonuse of effective contraceptive methods. Moreover, barriers including sex inequity, lack of partner support, ART shortages, and lack of HIV viral load monitoring were prevalent among the participants (P=0.001). However FPS use, ART compliance, and safe options to PMTCT significantly increased after the educational counseling interventions (P=0.001).ConclusionScaling up the FPS by incorporating routine PMTCT services into reproductive health care should contribute to preventing both horizontal and vertical transmission of HIV.

A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa

“…The review found that SCS were largely unavailable in sub-Saharan Africa outside of research settings, except for general availability (i.e., not for safer conception specifically) of ART and VMMC. Availability of SCS methods was greatest in public health facilities providing general services for people living with HIV [20–26, 31, 36, 39–44, 47–50, 56, 58, 59, 62, 63, 66–68]. More advanced or expensive strategies such as sperm washing, or PrEP remain unavailable in most public health facilities due to cost and lack of provider training [14–17, 23].…”

Prevalence and factors associated with fertility desires/intentions among individuals in HIV‐serodiscordant relationships: a systematic review of empirical studies

“…k These data were reported in the article of Kuete et al . (2016) . l The article of Mujugira et al .…”

“…Five of these were excluded because they remained unclarified, and two were excluded after the authors' clarification because they did not meet the eligibility criteria [44,45]. Because of overlapping samples, four articles ([46] and [47]; [48] and [49]) were considered as two studies. Priority was given to the articles of Beyeza-Kashesya et al [47] and Kuete et al [49].…”

“…j Inclusion and/or exclusion criteria were not clearly prespecified. k These data were reported in the article of [48]. l The article of Mujugira et al [84] described the design of the trial and the baseline characteristics of the Partners PrEP Study cohort.…”

Reproductive Disorders and Their Pathogenetic Mechanisms in Women With Hiv

“…Основными причинами прерывания беременности были: нежелательная беременность -50%, отсутствие материальных средств для самостоятельного существования, финансовая зависимость от партнера -28,5%, недостаточная информированность относительно возможности рождения здорового ребенка -21,5%. Невынашивание беременности (самопроизвольные аборты, неразвивающаяся беременность) выявлено у 21,5% ВИЧ-инфицированных женщин [5].…”