Modern contraceptive use and its associated factors among women taking anti retroviral therapy: Evidence from selected health institution of Addis Ababa, Ethiopia

Abstract

Background: Pregnancy among HIV positive individuals is an issue of public health importance because of poor maternal outcomes and pediatric HIV infections. Hence meeting contraceptive needs of people with HIV help avoiding unintended pregnancy and could reduce maternal death and pediatric HIV infection.

Objective: To assess contraceptive utilization and factors affecting its use among HIV positive women taking anti-retroviral therapy.

Methods: A cross sectional facility based quantitative study supplemented by qualitative in-depth interview (IDI) was conducted from January 2013 to June 2013 on a sample of 353 HIV positive women who had regular ART follow up in five major hospitals with large client flows in the capital city, Addis Ababa. A pretested structured questionnaire was used to collect the quantitative data and semi- structured (open ended) question was used to collect the qualitative data. The cleaned quantitative data were entered and analyzed using SPSS version 16 while the qualitative data were transcribed and analyzed into thematic areas.

Result: One hundred forty four (40.8%) of the respondents used at least one method of contraceptive method and condom was the most highly utilized contraception. The major determinant factors identified to augment contraceptive user were, having alive children (AOR=5.95; 95%CI= 3 to11), being married or cohabitated (AOR=0.15; 95%CI= 0 .08 to 0.27), age between 20-29 years (AOR=0.26; 95%CI=0.1 to 0.7); heard of  contraceptive method (AOR=5.91; 95%CI=1.7 to20), counseling on unintended pregnancy (AOR=1.87; 95% CI=1to3.4). According to the IDI responses, refusal of spouses and dislike of condom were the reasons mentioned for inconsistent condoms use while from the service provider views, fear of drug side effect was attributed to inconsistent contraceptive use.

Conclusion: In this study 40.8% of people living with HIV used at least one method of contraceptive method and condom being the leading  contraceptive methods. The major predictor identified for some program improvements need to target on women having alive child, in marital union, heard of contraceptive method, counseled on unintended pregnancy and age group between 20 and 29 years and ultimately avoid unintended pregnancy among HIV positive women.