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Winnie Muyindike , Robin Fatch , Nicholas Musinguzi , Nneka Emenyonu , Judy Hahn

Contraceptive Use and Associated Factors among Female Clients Enrolling into HIV care, Southwestern Uganda. Winnie Muyindike , Robin Fatch , Nicholas Musinguzi , Nneka Emenyonu , Judy Hahn. Background.

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Winnie Muyindike , Robin Fatch , Nicholas Musinguzi , Nneka Emenyonu , Judy Hahn

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  1. Contraceptive Use and Associated Factors among Female Clients Enrolling into HIV care, Southwestern Uganda Winnie Muyindike, Robin Fatch, Nicholas Musinguzi, NnekaEmenyonu, Judy Hahn

  2. Background • Preventing unwanted pregnancies among people living with HIV/AIDS is an important component of preventing mother to child transmission (PMTCT). • Preventing unwanted pregnancies is important in reducing morbidity and mortality that may be associated with attempts to terminate unwanted pregnancy. • In Uganda, HIV-1 sero prevalence among adults is 7.3% and 57 % of the HIV positives adults are women.

  3. Background • Uganda has one of the highest total fertility rates (TFR) worldwide –Previously 6.9 but now has fallen to 6.2 • Most PMTCT efforts to have prioritized provision of ARV prophylaxis leaving voluntary contraception an underutilized approach • Finding the associated factors of contraceptive use would enable improvement strategies aiming at increasing its uptake in HIV care settings and/other set ups.

  4. Aims of Study Broad Aims 1 - To document use of contraceptive method(s) at enrollment and at subsequent clinic visits 2 - To document the predictors to contraceptive use by HIV positive females. We hypothesized that HIV status disclosure to sexual partner(s) is associated to contraceptive use *This Presentation is focused on Results at Enrollment into HIV care

  5. Methods • Setting and Study Population – Semi rural, regional referral hospital in SW Uganda, HIV+ Females (18-49 years) enrolled in ISS clinic Jan-Dec 2009 • Data collection Routinely collected patient information recorded in the electronic Open MRS at the ISS clinic • Measurements - Outcome variable: recorded as using one or more FP methods - Predictor variables: HIV status disclosure and socio-demographic, behavioral and health factors

  6. Retrospective study of electronic medical records from female patients’ initial visits in 2009 to a semi rural HIV clinic in SW Uganda. • Analysis: Bivariate and multivariate logistic regression to examine associations between Contraceptive use and - clients’ demographic, - biological and - social behavioral predictors including HIV status disclosure to sexual partner(s)

  7. Results Total of 1036 unique females’ records analyzed 151 (14.6%) were pregnant 59 (5.7%) reported abstinence in last 3/12  so both these groups were excluded from the analysis. So N = 836 230 used FP (27.8%) 596 did not use any FP (72.2%),

  8. Frequency of Use of different FP methods

  9. Multivariate Analysis Showed • The odds of contraceptive use were significantly higher among women with: - Secondary education (OR 1.71, 95%CI: 1.09-2.68) - Monthly income over 250,000 USH (OR 5.54, 95%CI: 1.63-18.20), - Three or more children (OR 4.33, 95%CI: 1.55-12.11),

  10. Results Cont’ • Compared to women aged 18-24, 36-49 year old women had decreased odds of reporting Contraceptive use (OR 0.47, 95%CI: 0.27-0.83). • There was No significant association between HIV status disclosure to spouse, or partner HIV status and FP use.

  11. Discussion • Contraceptive use among HIV positive Females enrolling into care is Low (compares with that in the general population in Uganda Hence • There is need for Family Planning Programs to target all females (HIV + /_), • being mindful to reach even the more vulnerable women. • There is need for integration of FP programs into already existing HIV care clinics and other general health care points

  12. Acknowledgments • MUST ISS Clinic Team which collect this data routinely. • CFAR. • UCSF/ IeDEA • CAPT-Network. THANK YOU FOR LISTENING

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