HIV/AIDS and contraceptive use: Factors associated with contraceptive use among sexually-active HIV-positive women in Kenya

Magadi, Monica A.; Magadi, Winnie A.

Abstract

Objectives: With increased availability of anti-retroviral therapy and improved survival for people living with HIV, more HIV-positive women are leading full reproductive lives. However, HIV-positive women have special contraceptive needs/concerns. This paper examines the individual and community-level HIV/AIDS factors associated with contraceptive use and compares predictors of contraceptive uptake between HIV-positive and HIV-negative women in Kenya. Study design: The study is based on secondary analysis of cross-sectional data of a sample of 9132 sexually-active women of reproductive age from the Kenya Demographic and Health Surveys collected in 2003 and 2008. Multilevel logistic regression models are used to examine individual and contextual community-level factors associated with current contraceptive use. Results: The study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities. It further reveals striking differences in factors associated with contraceptive uptake between HIV-positive and HIV-negative women. Education and the desire to stop childbearing are strongly associated with contraceptive uptake among uninfected women, but both factors are not significant among HIV-positive women for whom wealth is the most important factor. While HIV-negative women in the richest wealth quintile are about twice as likely to use contraceptives as their counterparts of similar characteristics in the poorest quintile, this gap is about seven-fold among HIV-positive women. Conclusion: These findings suggest that having the desire and relevant knowledge to use contraceptives does not necessarily translate into expected contraceptive behavior for HIV-positive women in Kenya and that poor HIV-positive women may be particularly in need of increased access to contraceptive services.

Citation

Magadi, M. A., & Magadi, W. A. (2017). HIV/AIDS and contraceptive use: Factors associated with contraceptive use among sexually-active HIV-positive women in Kenya. Contraception, 95(3), 312-321. https://doi.org/10.1016/j.contraception.2016.10.013

• Journal Article Type: Article
• Acceptance Date: Oct 31, 2016
• Online Publication Date: Nov 9, 2016
• Publication Date: 2017-03
• Deposit Date: Nov 2, 2016
• Publicly Available Date: Nov 9, 2016
• Journal: Contraception
• Print ISSN: 0010-7824
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 95
• Issue: 3
• Pages: 312-321
• DOI: https://doi.org/10.1016/j.contraception.2016.10.013
• Keywords: HIV-positive women; Contraceptive uptake; Kenya; Multilevel logistic regression
• Public URL: https://hull-repository.worktribe.com/output/444861
• Publisher URL: http://www.sciencedirect.com/science/article/pii/S0010782416304802
• Additional Information: Authors' accepted manuscript of article published in: Contraception, 2017, v.95 issue 3.
• Contract Date: Nov 2, 2016