Dataset Information

Contraceptive counseling experiences among women attending HIV care and treatment centers: A national survey in Kenya.

ABSTRACT:

Objectives

To characterize contraceptive counseling experiences among women living with HIV (WLWH) receiving HIV care in Kenya.

Study design

Sexually active, WLWH aged 15 to 49 years were purposively sampled from 109 high-volume HIV Care and Treatment Centers in Kenya between June and September 2016. Cross-sectional surveys were administered to enroll women on a tablet using Open Data Kit. Poisson generalized linear regression models adjusted for facility-level clustering were used to examine cofactors for receiving family planning (FP) counseling with a provider.

Results

Overall, 4805 WLWH were enrolled, 60% reported they received FP counseling during the last year, 72% of whom reported they were counseled about benefits of birth spacing and limiting. Most women who received FP counseling were married (64%) and discussed FP with their partner (78%). Use of FP in the last month (adjusted Prevalence Ratio [aPR] = 1.74, 95% confidence interval [CI]: 1.41-2.15, p < 0.001), desire for children in >2 years (aPR = 1.18, 95% CI: 1.09-1.28, p < 0.001), and concern about contraceptive side-effects (aPR = 1.13, 95% CI 1.02-1.25, p < 0.05) were significantly higher among WLWH who received FP counseling compared to those that did not.

Conclusions

Over one-third of WLWH did not receiving FP counseling with an HIV care provider during the last year, and counseling was more commonly reported among women who were using FP or desired children in >2 years.

Implications

There are missed opportunities for FP counseling in HIV care. FP integration in HIV care could improve FP access and birth spacing or limiting among WLWH.

SUBMITTER: Dev R

PROVIDER: S-EPMC8286320 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

Contraceptive counseling experiences among women attending HIV care and treatment centers: A national survey in Kenya.

Dev Rubee R Kohler Pamela P Begnel Emily E Achwoka Dunstan D McGrath Christine J CJ Pintye Jillian J Muthigani Wangui W Singa Benson B Gondi Joel J Ng'ang'a Lucy L Langat Agnes A John-Stewart Grace G Kinuthia John J Drake Alison L AL

Contraception 20210422 2

<h4>Objectives</h4>To characterize contraceptive counseling experiences among women living with HIV (WLWH) receiving HIV care in Kenya.<h4>Study design</h4>Sexually active, WLWH aged 15 to 49 years were purposively sampled from 109 high-volume HIV Care and Treatment Centers in Kenya between June and September 2016. Cross-sectional surveys were administered to enroll women on a tablet using Open Data Kit. Poisson generalized linear regression models adjusted for facility-level clustering were use ...[more]

PMID: 33894251

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Project description:BACKGROUND: Researchers have widely documented the pervasiveness of HIV stigma and discrimination, and its impact on people living with HIV. Only a few studies, however, have analysed the perceptions of women living with HIV accessing sexual and reproductive health (SRH) services. This study explores the experiences of stigma of HIV-positive clients attending family planning and post-natal services and implications for service use and antiretroviral therapy (ART) adherence. Our aim was to gain a better understanding of the impact of various dimensions of stigma on service use and ART adherence among HIV clients in order to inform the response of integrated SRH services. METHODS: In-depth interviews were conducted with 48 women living with HIV attending SRH services in two districts in Kenya. Data were coded using Nvivo 8 and analysed using a thematic analysis approach. RESULTS: Findings show that many women living with HIV report high levels of anticipated stigma, resulting in a desire to hide their status from family and friends for fear of being discriminated against. Many women feared desertion following disclosure of their positive status to partners. Consequently some women preferred to hide their status and adhere to HIV treatment in secret. However, the majority of study participants attending postnatal care (PNC) services also revealed that anticipated stigma does not adversely affect their HIV drug uptake and ART adherence, as their drive to live outweighs their fear of stigma. Our findings also seem to suggest a preference for specialist HIV services by some family planning (FP) clients because of better confidentiality and reduced opportunities for unwanted disclosure that could lead to stigma. CONCLUSIONS: The findings highlight that anticipated stigma leading to low disclosure is widespread and sometimes reinforced by health providers' actions and facility layout (contributing to enacted stigma). However, the motivation to stay healthy and look after the children appears in many cases to override fears of stigma related to ART adherence in our client-based sample.

Project description:(1) Backgrounds and Objectives: with the rapid alteration in the socio-demographic pattern of the Saudi community, particularly the changes concerned with women's education and work force, contraceptive use must be a fundamental aspect in the life of women in reproductive age. The present study aimed to identify the prevalence and correlates of contraceptive use among women attending primary health centers in Aljouf region, Saudi Arabia, and to determine the perceived barriers of stopping or not using contraceptive methods in this population. (2) Methods: a primary health center-based cross-sectional study was conducted among 369 women of reproductive age. Data collection was done by using structured questionnaires distributed during face to face interviews with the participants. Data were analyzed using the SPSS program, version 24. (3) Results: most of the participants (n = 166; 45%) were current contraceptive users and 32.2% (n = 119) reported previous use of contraceptive methods. Pills were the most frequently used method (n = 203; 71.2%) and intrauterine devices (IUDs) came next (n = 67; 23.5%) while surgery was the least common method among the respondents (n = 3; 1.1%). Logistic regression analysis showed that the significant predictors of contraceptive use were: age > 35 years (odds ratio (OR): 4.52; confidence interval (CI): 1.56-15.42), Children number ? 4 (odds ratio (OR): 1.41; confidence interval (CI): 1.06-1.92) and monthly income ? 5000 Saudi Riyal (RS) (odds ratio (OR): 2.29; confidence interval (CI): 1.24-8.27). The most perceived barriers towards contraceptive utilization were cultural, demographic, medical, administrative, and barriers related to the method itself. The least reported barriers were psychosocial and physical. (4) Conclusions: the present study showed a high prevalence of contraceptive use among Saudi women in Aljouf region, Saudi Arabia. The study recommended sustained efforts to increase population awareness of the importance of family planning. Policymakers should discover the barriers that prevent contraceptive utilization by women.

Project description:BackgroundFor women living with the human immunodeficiency virus (WLHIV), preventing untimed pregnancies during the postpartum period reduces vertical transmission and improves other maternal and child health outcomes. In Kenya, Busia County's HIV prevalence and mother-to-child transmission rate are higher than the national average yet uptake of postpartum family planning (PPFP) is generally low. This study examined health system factors influencing the consistent use of PP modern FP methods among WLHIV in Busia County.MethodsA retrospective study involving 314 WLHIV with children aged 12-24 months who were chosen using systematic random sampling was conducted from February to March 2024 from outpatient clinics in Busia County. Additionally, 14 health providers were purposively sampled as key informants. Quantitative data was collected using a pretested questionnaire, while qualitative data was gathered through key informant interview guides. Quantitative data was analyzed using STATA 15 with descriptive statistics, logistic regression, and Chi-square tests, while a deductive thematic analysis was used for qualitative data.ResultsThe mean age of the participants was 32.06 (± 6.00) with the majority (51.27) aged between 25 and 34 years, married (74.84%) and unemployed (77.39%). Overall, 73.25% had used postpartum (PP) modern family planning (FP) methods, but only 52.55% reported consistent use throughout the first year postpartum. The only factors found to increase the odds of PPFP use were being married (aOR 3.34, 95% CI 1.58-7.07, p = 0.002), being escorted by a preferred person during seeking maternal and child health services (aOR 2.29, 95% CI 1.36-3.83, p = 0.002), and perceiving that they were provided information on all types of FP (aOR 2.33, 95% CI 1.19-4.16, p = 0.012). Persistent stock-outs and inadequate counseling hindered consistent PPFP use.ConclusionThe study identified gaps in the consistent use of PP modern FP methods among WLHIV in Busia County, influenced by the availability of FP information and health system factors. Addressing stock-outs and improving counseling during clinic visits and pregnancy are crucial for improving FP service delivery and reducing maternal and child health risks in high HIV-incidence areas like Busia County.

Dataset Information

Contraceptive counseling experiences among women attending HIV care and treatment centers: A national survey in Kenya.

Objectives

Study design

Results

Conclusions

Implications

Publications

Contraceptive counseling experiences among women attending HIV care and treatment centers: A national survey in Kenya.

Similar Datasets

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