Postpartum contraceptive use in HIV-positive women who started antiretroviral therapy in pregnancy in Cape Town

Shuuya, Reginald

Postpartum contraceptive use in HIV-positive women who started antiretroviral therapy in pregnancy in Cape Town

Thesis / Dissertation

2024

Publisher

University of Cape town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

Objective: This study described factors associated with at least one episode of unmet need for contraception up to 24 months postpartum in women who began ART during pregnancy in Gugulethu, Cape Town. Methods: This was a retrospective review of data from a broader trial of antiretroviral drug delivery to women living with HIV during the postpartum period. Between 11 January 2016 and 10 November 2017, a total of 409 women living with HIV who had been on ART for at least three months, were at least 18 years old and within 28 days of delivery were participated in the study. Interviews were conducted to get information on family planning use and pregnancy intentions. The proportion of women who do not want to get pregnant in the future and in the next 12 months and are not using contraception was used to estimate the unmet demand for contraception. The factors associated with unmet need for contraception up to 24 months postpartum in women who began ART during pregnancy were investigated using binary logistic regression. The outcome of interest is the episode of unmet need for contraception. Results: Contraceptive use was high at each visit with the uptake of 97.80% at the first visit (enrolment). The overall prevalence of unmet family planning need was 19.60%. Women who are not married in this study were (OR=2.09, 95% CI: 1.26-3.47) more likely to have an unmet need for family planning and women who had been pregnant twice or more were (OR=2.24, 95% CI: 1.66-3.03) more likely to have an unmet need for family planning compared to the once who had been pregnant once. Conclusion: Contraceptive use among these women was high. The findings highlight that unmet need remains a source of concern in unmarried women and those who have been pregnant more than once. The findings can help drive national public health strategies to meet unmet contraceptive needs in women living with HIV through improving family planning initiatives and more effectively integrating family planning services into HIV treatment facilities.

Keywords

Medicine

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