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Factors associated with premarital HIV testing among married women in Ethiopia.

ABSTRACT: BACKGROUND:Premarital HIV testing is the key entry point in prevention, care, treatment, and support services, in which people learn their HIV status and its implications to make informed decisions about their health. This study was, therefore, conducted to identify factors associated with premarital HIV testing among married women in Ethiopia. METHODS:A cross-sectional study design was used, and secondary data analysis was done using 2016 Ethiopian demographic health survey (EDHS). Two-stage stratified cluster sampling technique was used. The data were analyzed by using SPSS version 20. Frequencies and weighted percentage of the variables, and second-order Rao-Scott statistic were computed. Multivariate logistic regression analysis was performed to control confounders and to identify predictors of premarital HIV testing. Adjusted odds ratio with 95% confidence interval was considered to declare statistically significant associations. RESULT:The total sample comprised 9602 married women. In this study, the odds of premarital HIV testing were associated with being urban residents (AOR: 1.81; 95% CI: 2.74-5.20), attended primary education (AOR:1.54; 95%:1.27-1.87), secondary education (AOR:2.34; 95% CI:1.70-3.23), higher education (AOR:2.92; 95% CI:1.90-4.50), access to media (AOR: 1.44; 95% CI:1.20-1.76), being rich (AOR: 1.52; 95%CI:1.12-2.07), andrichest (AOR: 1.67;95%CI:1.15-2.44), known the place of HIV testing (AOR: 4.95; 95% CI:3.44-7.11), discriminatory attitude to PLHIV (AOR: 1.47; 95%CI:1.23-1.76), being khat chewer(AOR: 1.60;95%CI:1.11-2.31), and alcohol drinker (AOR: 1.55; 95% CI:1.27-1.90). CONCLUSION:It is possible to conclude that being urban resident, attending education (primary, secondary, higher), media access, improved wealth index, knowing the places for HIV testing, chewing khat, drinking alcohol, and having discriminatory attitude towards PLHIV were positively associated with premarital HIV testing. The Ethiopian government needs to step up efforts to expand education for all Women. Advancing access to HIV testing for rural women may also increase premarital HIV testing services uptake. Further qualitative researches need to be done to assess the relationship between discriminatory attitude towards PLHIV and premarital HIV testing.

SUBMITTER: Ahmed M

PROVIDER: S-EPMC7398550 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Factors associated with premarital HIV testing among married women in Ethiopia.

Ahmed Mohammed M Seid Abdu A

PloS one 20200803 8

<h4>Background</h4>Premarital HIV testing is the key entry point in prevention, care, treatment, and support services, in which people learn their HIV status and its implications to make informed decisions about their health. This study was, therefore, conducted to identify factors associated with premarital HIV testing among married women in Ethiopia.<h4>Methods</h4>A cross-sectional study design was used, and secondary data analysis was done using 2016 Ethiopian demographic health survey (EDHS ...[more]

PMID: 32745083

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Project description:BackgroundAfrica is the most severely affected area, accounting for more than two-thirds of the people living with HIV. In sub-Saharan Africa, more than 85% of new HIV-infected adolescents and 63% of all new HIV infections are accounted for by women. Ethiopia has achieved a 50% incidence rate reduction. However, mortality rate reduction is slow, as the estimated prevalence in 2021 is 0.8%. In sub-Saharan Africa, heterosexual transmission accounts for the majority of HIV infections, and women account for 58% of people living with HIV. Most of these transmissions took place during marriage. Thus, this study aimed to explore the spatial variation of premarital HIV testing across regions of Ethiopia and identify associated factors.MethodsA cross-sectional study design was employed. A total of 10223 weighted samples were taken from individual datasets of the 2016 Ethiopian Demographic and Health Survey. STATA version 14 and ArcGIS version 10.8 software's were used for analysis. A multilevel mixed-effect generalized linear model was fitted, and an adjusted prevalence Ratio with a 95% CI and p-value < 0.05 was used to declare significantly associated factors. Multilevel models were compared using information criteria and log-likelihood. Descriptive and spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R-squared. The local coefficients of spatial explanatory variables were mapped.ResultsIn spatial regression analysis, secondary and above education level, richer and above wealth quintile, household media exposure, big problem of distance to health facility, having high risky sexual behaviour and knowing the place of HIV testing were significant explanatory variables for spatial variation of premarital HIV testing among married women. While in the multilevel analysis, age, education level, religion, household media exposure, wealth index, khat chewing, previous history of HIV testing,age at first sex, HIV related knowledge, HIV related stigma, distance to health facility, and community level media exposure were associated with premarital HIV testing among married women.Conclusions and recommendationPremarital HIV testing had a significant spatial variation across regions of Ethiopia. A statistically significant clustering of premarital HIV testing was observed at Addis Ababa, Dire Dawa, North Tigray and some parts of Afar and Amhara regions. Therefore area based prevention and interventional strategies are required at cold spot areas to halt the role of heterosexual transmission in HIV burden. Moreover, the considering the spatial explanatory variables effect in implementations of these strategies rather than random provision of service would make regional health care delivery systems more cost-effective.

Project description:BackgroundPremarital HIV testing offers an opportunity where prospective couples can know their HIV status before marriage to prevent both heterosexual and vertical transmission of HIV. Therefore, this study aimed to determine whether there is any significant difference in the prevalence of premarital HIV testing among women who had autonomous versus non-autonomous marriage, and to investigate the factors associated with premarital HIV testing among women who had autonomous versus non-autonomous marriage in Ethiopia.MethodsData were extracted from 2016 Ethiopia Demographic and Health Survey dataset and analyzed by using SPSS version 20. Frequencies and weighted percentage of the variables, and second-order Rao-Scott statistic were computed. Multivariable logistic regression analysis was used to identify factors between the two groups. An adjusted odds ratio with 95% confidence interval was considered to state statistically significant associations.ResultFrom 9602 included sample, 4,043 (42.1%) of the women had autonomous marriage, and 5,559(57.9%) of the women had non-autonomous marriage. The prevalence of premarital HIV testing in Ethiopia among women who had autonomous marriage was 30.5% (95% CI: 27.7-33.4%) compared to 20.6% (95% CI: 18.5-22.8) among women who had a non-autonomous marriage. No differences in associated factors were found between women who had autonomous versus non autonomous marriage to uptake HIV testing. In both groups, residence in rural area, education attainment (primary, secondary, higher), media access, being rich and richest, knowing the places for HIV testing, chewing chat, and drinking alcohol were significantly predicts premarital HIV testing.ConclusionThe study indicated that 10% more women in autonomous marriage tested for HIV relative to non-autonomous women whilst being an urban resident, educated, having access to media, household wealth and knowledge of testing facilities significantly predict HIV testing among women in Ethiopia. The paper recommends the Ethiopian government shall expand access to education among women while improving their access to media to enhance their socioeconomic wellbeing and health. Furthermore, it is better to inspire women to undergo autonomous marriage by fostering education in the community to enhance premarital HIV testing.

Project description:Premarital sexual intercourse has essential implications for the sexual and reproductive health and rights of young women. These include increased sexual pleasure and satisfaction as well as exposure to the risks of unintended pregnancy and sexually transmitted infections, including HIV/AIDS. This study examined the trends, patterns, and associations of premarital sexual intercourse among young women aged 15-24 in Sierra Leone. Nationally representative cross-sectional data from the 2008, 2013, and 2019 Demographic and Health Surveys in Sierra Leone were used for the study. A weighted sample of 9,675 never-married young women was used to estimate the pooled prevalence of premarital sexual intercourse in Sierra Leone. Percentages were used to present the results of the trends and patterns of premarital sexual intercourse. We employed a multilevel binary logistic regression modelling technique to examine the associations of premarital sexual intercourse. The results were presented using adjusted odds ratio with their respective 95% confidence interval. The pooled prevalence of premarital sexual intercourse among the young women in Sierra Leone was 62.9%. Over the survey years, premarital sexual intercourse increased from 59.8% in 2008 to 65.1% in 2013. However, it declined by 3.5% to 61.6% in 2019. Young women aged 20-24 (aOR = 12.47, 95% CI = 10.54-14.76) had higher odds of engaging in premarital sexual intercourse than those aged 15-19. Young women with higher educational levels (aOR = 1.87, 95% CI = 1.17-2.99), those who were working (aOR = 1.60, 95% CI = 1.44-1.78), those who listened to the radio (aOR = 1.33, 95% CI = 1.29-1.60), and those who lived in the Northwestern (aOR = 2.19, 95% CI = 1.68-2.84), Eastern (aOR = 1.47, 95% CI = 1.23-1.760, Northern (aOR = 1.48, 95% CI = 1.25 -, 1.76), and Southern (aOR = 1.63, 95% CI = 1.36-1.94) regions were more likely to engage in premarital sexual intercourse compared to those with no formal education, those not working, those who did not listen to the radio, and those who lived in the Western region, respectively. Young women in the richest wealth category (aOR = 0.62, 95% CI = 0.49-0.78), and residing in rural areas (aOR = 0.84, 95% CI = 0.72-0.98) had lower odds of engaging in premarital sexual intercourse relative to those from the poorest wealth quintile and those living in urban areas. Our study found a high prevalence of premarital sexual intercourse among young women in Sierra Leone. Premarital sexual intercourse was associated with age, educational level, wealth, employment, and region. This necessitates providing them with comprehensive information regarding sexual and reproductive health behaviours, specifically emphasising the benefits and adverse consequences of engaging in sexual experimentation. Additionally, it is crucial to promote the adoption of abstinence, injections, implants, and condom usage through consistent advocacy for youth-risk communication.

Project description:Background. Modern contraceptives are a key intervention to improve the health of both the mother and children by preventing unintended pregnancy. However, significant numbers of women were facing abortion-related morbidity and mortality globally including Ethiopia due to the nonuse or failure of contraceptive uses. Therefore, the aim of this study was to assess the utilization of modern contraceptive methods and associated factors among married Gumuz women in Metekel Zone North West Ethiopia. A community-based cross-sectional study was conducted among 580 women from March 1 to 30/2019. Pretested structured interview administer questionnaires was used to collect the data. Data were cleaned, coded, and entered into Epi-info version 7.1 and export to SPSS for farther analysis. Both bivariate and multivariate analyses were used. On bivariate analysis P value, less than 0.2 were used to select the candidate variable for multivariate analysis. P value and 95% confidence interval were used to measure the level of significance on multivariate analysis and those variables whose P value < 0.05 were considered as statically significant. The prevalence of modern contraceptive method was 18.6% [95% CI: 15.00-22.00]. Age ? 35 year AOR 4.67; 95% CI (1.34 -16.18), able to read and write AOR 6.45 95% CI(2.98-13.97), primary school AOR 6.56; 95% CI (2.22-19.38), secondary school AOR 7.27; 95% CI (3.00 -17.61), counseled on contraceptive methods AOR 3.72 95% CI (2.11-6.56), moderate knowledge on modern contraceptive method AOR 2.31; 95% CI (1.15-4.64), and good knowledge on modern contraceptive method AOR 4.37; 95% CI (2.38-8.02) were identified as statistically significant with modern contraceptive methods utilization. The prevalence of contraceptive utilization was low when compared to the national and the regional figure. Maternal age, maternal educational status, counseling about modern contraceptive methods, and knowledge on modern contraceptive methods were found as statistically significant with modern contraceptive utilization.

Project description:BackgroundUnmet family planning is one of the common causes for low contraceptive prevalence rates in developing countries, including Ethiopia. Rapid urbanization had profound effect on population health, however, little is known about the unmet need of family planning in settings where there was increased industrializations and internal migrations in Ethiopia. This study aims to determine the unmet need for family planning services among currently married women and identify factors associated with it in Bishoftu town, Eastern Ethiopia.MethodsCommunity-based cross-sectional study was conducted from 1st January to 28th February, 2021 among 847 randomly sampled currently married women of the reproductive age group. Data were collected using semi structured interviewer administered questionnaire. Multivariate logistic regression was used to identify factors associated with the outcome variable and a 95% confidence interval was used to declare the presence of statistical significance associations.ResultsEight hundred twenty-eight women were participated in the study. The prevalence of unmet need for family planning among currently married women was 26% [95% CI: 23,29]. Maternal age [AOR, 3.00, 95% CI:1.51-5.95], educational status [AOR, 2.49, 95% CI:1.22-5.07], occupational status of self-employee [AOR, 1.98, 95% CI:1.15-3.39] and housewife [AOR, 1.78, 95% CI:1.02-3.12], being visited by health care provider in the last 12 months [AOR, 1.81, 95% CI: 1.26-2.60] and desired number of children less than two [AOR, 1.53, 95% CI:1.01-2.30] were significantly associated with unmet need for family planning.ConclusionsUnmet need for family planning was higher in the study area compared with the United Nations sphere standard of unmet need for family planning and the national average, and slightly lower than the regional average. Socio-demographic, economic, and health institution factors were determinants of the unmet need for family planning in the study area. Therefore, health education and behaviour change communication related to family planning services should be strengthened and access to family planning services should be improved.

Project description:Background:Globally, unintended pregnancy has been very high accounting for 27% of maternal deaths. Different studies noted that nearly half of HIV positive women who gave unintended birth were using contraceptive methods prior to their unintended pregnancy. This implies that contraceptive failure contributes to unintended pregnancy. Long-term and permanent contraceptive methods are safe and effective contraceptive options. In women who are using long acting and permanent methods, the unintended pregnancy rate is very low and it is almost the same both in typical and perfect users. However, there is limited information on factors that affect long acting and permanent contraceptive methods utilization among Human Immuno-deficiency Virus (HIV) positive women in Ethiopia. Therefore, the purpose of this study was to assess long acting and permanent contraceptive utilization and its associated factors. Methods:An institution-based cross-sectional study was conducted among 505 married women attending care at Anti Retroviral Therapy (ART) clinics in Bahir Dar from March 16, 2014 to April 15, 2014. The data were collected using a structured and interviewer administered questionnaire. Both bivariate and multivariate logistic regressions were used to identify associated factors. Results:A total of 505 married women participated in the study with a response rate of 99.6%. The utilization of long acting and permanent contraceptive methods (LAPMs) was 27.5% [95% CI, 23.8-31.5]. The multivariate analyses showed that women who were getting pre- anti retroviral therapy (Pre-ART) services [Adjusted Odds Ratio?=?2.65, 95% confidence interval: 1.44, 4.86], had spousal discussion on family planning sometimes [Adjusted Odds Ratio?=?6.03, 95% CI:2.42-15.01] and frequently [Adjusted Odds Ratio?=?6.61, 95% confidence interval: 2.49-17.47], had previous experience on long acting contraceptive methods [Adjusted Odds Ratio?=?9.06, 95% confidence interval: 5.38-15.26], no exposure to myths about LAPMs [Adjusted Odds Ratio?=?2.07, 95% confidence interval: 1.24-3.45], had birth intention after 2 years [Adjusted Odds Ratio?=?6.95, 95% confidence interval: 3.35-14.42], and no such intention [Adjusted Odds Ratio?=?7.60, 95% confidence interval: 3.77-15.34] were factors significantly associated with utilization of long acting and permanent contraceptive methods. Conclusion:The utilization of long acting and permanent contraceptive methods was relatively high. Discussion with partners on family planning, previous experiences of LAPMs, not hearing myths about LAPMs, women not started ART, and no birth intention were positively associated with LAPMs utilization. It is therefore recommended that health service providers need to make couples counseling on FP, undergo behavioral change communication (BCC) to avoid misconceptions/myths regarding LAPMs. Further research is also recommended to address the gaps mentioned in the limitation section and to explore the reason/s for not using LAPMs (qualitative study).

Project description:BackgroundUnmet need for family planning is a measure of the gap between women's contraceptive behavior and their fertility desires. It should be measured among different population groups to effectively implement public health interventions. Thus, this study aimed to determine the magnitude of unmet need for family planning and associated factors among HIV- positive women in Dire Dawa city Anti-retroviral treatment (ART) clinics, Eastern Ethiopia.MethodsWe carried out a facility-based cross-sectional study (March-June 2020) among 409 married women aged 15-49 on ART, using systematic random sampling. A face-to-face interview was done using a structured questionnaire. Bivariable and multivariable logistic regression was done to identify factors associated with unmet need for family planning.ResultsOverall, 33% [95% confidence interval (CI): 28.9-37.9] of the respondents had unmet need for family planning. Woman's residing in a rural area (adjusted odds ratio (AOR): 2.41 [95% CI: 1.24-4.67]), woman's not attained formal education (AOR: 4.14 [95% CI: 1.73-9.93]) and attaining primary education (AOR: 2.97 [95% CI: 1.54-5.74]), poor knowledge (AOR: 2.87 [95% CI: 1.52-5.40]), and unfavorable attitude towards family planning (AOR: 2.21 [95% CI: 1.12-4.34]), clients not satisfied with family planning service (AOR: 6.34 [95% CI: 3.31-12.15]), the woman not having decision making power on family planning (AOR:3.97 [95% CI: 2.14-7.38]) and not getting family planning counseling in ART clinics (AOR: 2.87 [95% CI: 1.54-5.35]) were positively associated with having unmet need for family planning.ConclusionThis study indicates there a high unmet need for family planning among married HIV-positive women. Factors like a place of residence, educational status of women, knowledge and attitude towards family planning, client satisfaction with FP service, women decision-making power, and FP counseling service in ART. Therefore, we recommend that the concerned bodies should collaborate with ART clinics to design interventions that enhance access to family planning programs to combat the high unmet need for family planning among HIV-positive women.

Project description:BackgroundAnemia is one of the world's public health problem, especially in developing nations. The majority of women of childbearing age (15-49) are affected by anemia. Women's role in the decision-making process is significant for their health and related issues such as anemia. So far, there is no evidence of women's decision-making autonomy on anemia. Consequently, this study aimed to robustly examine both individual- and group-level women's decision-making autonomy and other determinants of anemia among married women in Ethiopia.MethodsWe examined data from an Ethiopian demographic and health survey conducted in 2016. Our analysis included 9220 married women of childbearing age (15-49 years). For bivariate analysis, we applied the chi-squared (X2) test. The relationship between individual and group-level women's decision-making autonomy and anemia was assessed using multilevel binary logistic regression models while adjusting other socio-demographic and economic characteristics.ResultsIn this study the magnitude of anemia was 30.5% (95% CI; 29.5-31.4). According to our multilevel analysis, group-level women's autonomy was found to be negatively related with anemia than individual-level women's autonomy (AOR = 0.53, 95% CI = 0.41-0.69). In addition, the indicator of women's wealth index at group level was a protective factor (AOR = 0.68, 95% CI =0.51-0.90) to develop anemia. Among individual-level indicators women's age (AOR = 0.73, 95% CI = 0.60-0.89), use of contraceptive (AOR = 0.66, 95% CI = 0.55-0.81), BMI (AOR = 0.71, 95% CI = 0.59-0.86) and employment status (AOR = 0.88, 95% CI = 0.79-0.98) were negatively related with anemia. While women who follow Muslim religion (AOR = 1.62, 95% CI = 1.32-1.97,), women who had five and above number of children (AOR = 93, 95% CI = 1.53-2.46), and who were pregnant (AOR = 1.21, 95% CI = 1.04-1.40) were positively associated with anemia. Our final model showed that around 27% of the variability of having anemia was because of group-level differences (ICC = 0.27, P < 0.001). In addition, both individual and group-level factors account for 56.4% of the variance in the in the severity of anemia across communities (PCV = 56.4%).ConclusionsOur study showed that empowering women within households is not only an important mechanism to reduce anemia among married women but also serves as a way to improve the lives of other women within the society.

Dataset Information

Factors associated with premarital HIV testing among married women in Ethiopia.

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Factors associated with premarital HIV testing among married women in Ethiopia.

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