Unmet Need for Contraception Use among HIV Positive Women in Kwale County, Kenya

Abstract

Introduction: The HIV pandemic has been one of the biggest challenges in public health across the world since its emergence. Millions are still getting infected every year, despite all the efforts made to prevent new infections. The use of modern contraceptives is one of the strategies used in preventing vertical transmission of HIV by averting unplanned pregnancies, yet the uptake among HIV infected women is still below expectations especially in rural communities with fewer resources. Therefore this study aimed to determine the contraceptive use among HIV- positive women in Kwale County, Kenya.

Materials and Methods: The cross-sectional study design was used, interviewing 347 HIV positive women aged 15-49 years who had been attending selected Comprehensive Care Clinics in Kwale County, for at least three months. Questionnaires were used between March and April 2021 to collect data from participants based on a systematic sampling with a skip interval used to select the participants. Data were managed and analysed using Ms Excel and STATA 16, respectively. A P-value of <0.05 was considered statistically significant.

Results: The contraceptive prevalence rate was 79% (95% CI 74.3; 82.9) and the unmet need for contraception was 21% with 18% and 3% was the unmet need for limiting and spacing, respectively. The most commonly used modern contraceptive methods were injectables (48%) followed by implants (36%) then condoms (8%) and 4% were on hormonal pills. Older women aged between 45 and 49 had the highest unmet need for contraception (16;4.6%)[ X²=53.9031, p=0.000]. Marital status [X²=68.7855, p=0.000] and parity [X²=, 7.9921 p=0.018] were also associated with contraceptive use.

Conclusion: The contraceptive prevalence rate and unmet needs were 79% and 21% respectively among HIV-positive women of childbearing age in Kwale County. Age of 45-49 years, widowed, and nulliparous status was associated with unmet needs for contraception.

Recommendations: Literature indicates that spousal support encourages women to use contraceptives. Therefore, National and local governments should prioritize endorsing policies and programs targeting widowed and unmarried women to encourage them to utilize modern contraceptives.