Incidences of Pregnancy During Concurrent Use of Hormonal Contraceptives and Antiretroviral Therapy at Nakuru County Referral and Teaching Hospital in Kenya

Abstract

With concerns on the efficacy and effectiveness of hormonal contraceptives and antiretroviral therapy in curbing incidences of unplanned pregnancies among women living with Human Immunodeficiency virus infection, a study to examine these concerns was carried out at  Nakuru County Referral and Teaching Hospital (NCRTH). A cross-sectional retrospective study was carried out at the Comprehensive Care  Centre (CCC) at NCRTH from March 2023 to April 2023 with a sample size of 226 participants however the estimated sample size using the  Taro Yamane formula was 358. Data was collected using structured questionnaires with both open and close-ended questions and  analyzed using the Statistical Package for Social Sciences (SPSS). Frequency tables, bar graphs, and percentages were used to present  descriptive statistics. Chi-square was used to conduct inferential statistics, and P<0.05 was considered significant. The majority (86.7%) of  participants were on TLD (Tenofovir, Lamivudine, Dolutegravir). Most participants (37.17%) had used ART for 6-10 years. 79.65% of  participants avoided pregnancy with concurrent hormonal contraceptives and ART, while 20.35% experienced pregnancies. 15.22% of  pregnant participants also used other medications, especially anti-TBs, due to drug-drug interactions. Injectables were the most common  contraceptive (41.3%) used by participants who had pregnancy incidences. A significant association was noted between the  incidence of unplanned pregnancy and the use of combined oral contraceptives. Incidences of unplanned pregnancies were higher  among those aged 30-34 (32.61%), married (73.91%), with secondary education (43.48%), self-employed (60.87%), and Protestant  (73.91%). From this study, TLD was the most commonly used antiretroviral, injectables were the most commonly used contraceptive, and  the majority of the participants had used antiretrovirals for 6-10 years. Despite the concurrent use of hormonal contraceptives and  antiretrovirals to avoid pregnancy incidences, 20.35% of the participants had unplanned pregnancy incidences. 15.22% of these participants who got pregnant were using other medications. Unplanned pregnancies were more common among certain demographic  groups. From this study, data on pregnancy incidents during concurrent use of hormonal contraceptives and antiretroviral therapy is availed however limitations such as study design and time limit necessitate more research. To reduce the risk of unplanned pregnancies and ensure the appropriate use of hormonal contraceptives, more support and counseling programs should be established for women using antiretrovirals.