Utilization of dual contraception method among reproductive age women on antiretroviral therapy in selected public hospitals of Northern Ethiopia

Abstract

BackgroundSexually transmitted infections are highly prevalent among pregnant women in Africa. Among the incidence of HIV infection in children, 90% of the infection is attributable to their mothers. Ethiopia is one of the countries with an increasing risky sexual behavior and the most affected by the HIV epidemic. If prevention of mother to child transmission focuses on increasing contraception, it will prevent more than 29% of HIV infection at birth. Therefore, the aim of this study was to assess utilization of dual contraceptive method and associated factors among reproductive age women on antiretroviral therapy in selected public hospitals of Mekelle town, Northern Ethiopia.MethodsInstitution based cross-sectional survey was conducted in selected public hospitals of Mekelle among women under antiretroviral therapy from March 1–April 31, 2016. We used a systematic sampling technique to select 331 women. A pretested interviewer administered questionnaire was used for data collection. The data were entered in to Epi data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable logistic regression analysis was computed. Odds ratio along with 95% CI was computed to ascertain the association. Statistical tests at p-value of < 0.05 were considered as cut off point to determine statistical significance.ResultsOnly 51(15.7%) of participants have utilized dual contraception method. Being single[AOR 5.43, 95% CI (1.61, 18.32)] and cohabitated [AOR 6.06; 95% CI: (2.16, 16.95)] in marital status, having HIV negative partner [AOR 4.44; 95% CI: (1.23, 16.04)], exposure to post diagnosis counseling [AOR 3.03; 95% CI: 1.34, 6.80], disclosed HIV status [AOR 6.06; 95% CI: (1.78, 20.87)] and discussing safer sex with partner [AOR 6.96; 95% CI: (2.75, 16.62)] were positively associated with utilization of dual contraceptive method.ConclusionThe overall magnitude of dual contraceptive use is still low in this study. This will be a great concern on the transmission of the virus from mother to babies and partners and risk of complications following unintended pregnancy. This will continue to present as major public health problems in the region unless future interventions focuses on the barriers through tailored counseling and husband involvement in all aspects of the HIV/AIDS care.Electronic supplementary materialThe online version of this article (10.1186/s12978-017-0390-6) contains supplementary material, which is available to authorized users.

Positive deviance for dual-method promotion among women in Uganda: study protocol for a cluster randomized controlled trial

“…Model 2 will be adjusted for the status of residence (urban or rural) in addition to demographic variables. Model 3 will include the type of HECs at the baseline sequentially, which is known to be associated with dual-method use [8,45]. Model 4 will be adjusted for variables related to their partners, such as partner's attitude toward family planning.…”

“…Outcomes The primary outcome is dual-method use. In this study, dual-method use is defined as the use of male or female condoms along with HECs such as pills, injectables, implants, male and female sterilization, and IUD consistently in the last 2 months, before each follow-up interview [8]. The outcome measure combines two questions regarding the frequency of condom use and HEC use.…”

“…Dual protection is defined as protection against the dual risks of unintended pregnancies and HIV/STIs [8]. It can be accomplished by either using a condom consistently alone or with HECs (dual-method use) [8].…”

“…However, as they are often used incorrectly and inconsistently, condoms can only prevent 85% of pregnancies [10]. Dual-method use, thus, has been recommended as the most reliable protection against the dual risks in couples who do not want a child or who want to delay childbirth [7,8,11,12]. Nevertheless, it remains uncommon [11].…”

“…In SSA, most research has focused on dual-method use among women living with HIV and adolescents. For instance, 16% and 39% of women living with HIV practiced dualmethod in 3 months in Ethiopia and Kenya, respectively [8,14], while 7% of South African adolescents aged 15-24 years reported dual-method use [15].…”