Fertility intentions and contraceptive practices among clinic-users living with HIV in Kenya: A mixed methods study
Background: Preventing unwanted pregnancies in Women Living with HIV (WLHIV) is a recognised HIV-prevention strategy. This study explores the fertility intentions and contraceptive practices of WLHIV using services in Kenya. Methods: Two hundred forty women self-identifying as WLHIV who attended reproductive health services in Kenya were interviewed with a structured questionnaire in 2011; 48 were also interviewed in-depth. STATA SE/13.1, Nvivo 8 and thematic analysis were used. Results: Seventy one percent participants did not want another child; this was associated with having at least two living children and being the bread-winner. FP use was high (92%) but so were unintended pregnancies (40%) while living with HIV. 56 women reported becoming pregnant “while using FP”: all were using condoms or short-term methods. Only 16% participants used effective long-acting reversible contraceptives or permanent methods (LARC-PM). Being older than 25 years and separated, widowed or divorced were significant predictors of long-term method use. Qualitative data revealed strong motivation among WLHIV to plan or prevent pregnancies to avoid negative health consequences. Few participants received good information about contraceptive choices. Conclusions: WLHIV need better access to FP advice and a wider range of contraceptives including LARC to enable informed choices that will protect their fertility intentions, ensure planned pregnancies and promote safe child-bearing.
Mayhew, Susannah H., Manuela Colombini, James Kelly Kimani, Keith Tomlin, Charlotte E. Warren, on behalf of the Integra Initiative, and Richard Mutemwa. 2017. "Fertility intentions and contraceptive practices among clinic-users living with HIV in Kenya: A mixed methods study," BMC Public Health 17: 626.
Assessing the Benefits of Integrated HIV and Reproductive Health Services: The Integra Initiative