Prevalence of and Barriers to Dual-Contraceptive Methods Use among Married Men and Women Living with HIV in India (original) (raw)
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The Indian journal of medical research, 2016
Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women. An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year. At the end of one year, 60 per cent women in the intervention group reached Family Planning centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods al...
Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program's potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people. To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV. A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire. In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual ...
2020
Background HIV is a major global health issue, targeting the immune system and making the body prone to diseases. People living with HIV mostly face societal stigma and fear of disclosure resulting in discrimination of accessing health facilities leading to multiple sex partners, increased sexual activity and less use of condoms. HIV positive women are at risk of transmitting HIV to their infants and their partners. Thus, the family planning services if provided to PLHIV can help to improve their and families health. In addition to, it reduces the risk of mother-to-child transmission (PMTCT). The facts related to PLHIV with respect to pregnancy and childbearing are not available. The purpose of this study is to focus on the status of the use of family planning methods and explore factors affecting the utilization among people living with HIV and AIDS in Kathmandu valley of Nepal. The study is expected to contribute in enhancing the present understanding of PLHIV towards family planning. Methods The cross sectional descriptive method was used for the research. The study followed Population proportion to size method for the calculation of the respondents from four ART sites of Kathmandu Valley. Structured questionnaire used previously in similar research has been adopted with necessary question related to dual contraceptive use. Results The mean age group of the respondents was (39.16 ± 6.969) years. More than two third respondents (69.5%) were Hindu. 34.8% respondents were married at the less than 20 years of age. Almost three-fourth of the PLHIV (74.4%) were literate where more than three fourth (79.3%) their spouses were literate and educated. About half of the respondents (43.9%) were found to be involved in professional/ technical/ managerial. More than half of the respondent's spouses (63.4%) were HIV positive. All the respondents (100%) respondents had disclosed their status to their partners. Neither the respondents nor their partner had fertility desire. 28% of neither respondents nor their partners had used the family planning methods before HIV diagnosis. More than half (60.4%) of the respondents had sexual intercourse prior to last 6 months. 15.9% of the respondents positively responded to use of dual protection. Only 11% either respondents or their partners had used the emergency contraceptive pill. 17.7% respondents did not use any family planning. This study revealed that almost half of the respondents (48.8%) had the good knowledge on the use of contraception. Conclusion The use of dual protection is much less than the half of the respondents. Therefore, counseling and health education towards motivating PLHIV on using dual FP methods to avoid the risk of HIV, STIs and unplanned pregnancy is encouraged.
AIDS Patient Care and STDs, 2010
This investigation examined sexual behaviors among heterosexual persons living with HIV (PLHIV) in India. Study participants (mostly married) were interviewed during August to November 2006 in five Indian states using a quantitative survey (n ¼ 100 men and 100 women), eight focus groups (n ¼ 58 participants), and in-depth interviews (n ¼ 31). One third of men and one fourth of women reported inconsistent condom use with regular sexual partners. Facilitators of condom use with regular partners included a feeling of personal responsibility to protect the health of the partner, desire to prevent acquisition and=or transmission of sexually transmitted infections, and the belief that condoms are needed for antiretroviral therapy to be effective. Barriers to consistent condom use with regular partners included the belief that condoms are unnecessary in HIV-positive seroconcordant relationships; lack of sexual satisfaction with condoms; the desire to have a child; husband's alcohol use, depression, and anxiety; fear that disclosure of HIV status will bring marital discord and family shame; and inadequate counseling by health care providers. Positive prevention programs should include counseling about benefits of safer sex in HIV-positive seroconcordant relationships, counseling about integrating condom use with sexual satisfaction and intimacy, condom use self-efficacy and negotiation skills-building, family planning counseling, mental health and alcohol dependence treatment, and counseling and skills-building about disclosure. Health care providers must be trained to provide these services. Furthermore, efforts are needed to promote tolerance for family planning choices made by couples and to counter the stigma associated with HIV=AIDS and condoms in the broader society.
Clinical Epidemiology and Global Health , 2021
Background: HIV/AIDS epidemic is one of the most serious global public health problems, more particularly seen in low and middle-income countries. Females contribute around 40% of total HIV cases in India who predominantly belong to fertile age group. This study aimed to assess the contraceptive utilization patterns and factors affecting the HIV-positive Indian women. Methods: A cross-section of 400 confirmed HIV-positive women aged between 18 and 45 years were recruited. All the relevant information including socio-demographic and anthropometric details were collected from the participants. All other needed parameters were recorded from patients file. The SPSS ver. 21 was used to perform statistical analysis. Results: The mean age of the participants was found to be 29.53 ± 5.35 years. The majority of women were housewives (97%), Illiterate (58.8%) and 90.5% had a monthly family income under 10,000 INR. Maximum (82.8%) of HIV transmission was found through unprotected sexual routes while 68.8% of patients were on HAART. Male condoms were highly utilized whereas 44.3% of participants never used any methods. Percentage of consistent contraceptive use was highest when patients were educated to graduate level (66.7%), aware of contraception methods (49.8%) and who have a monthly income more than 20,000 INR (66.7%). Conclusion: This study gives a real picture of the contraceptive utilization among HIV-infected women from rural regions of India. The study anticipates the immediate needs in healthcare sector to improve awareness of patients regarding modern methods of contraception and effective family planning strategies.
Condom use within marriage: a neglected HIV intervention
Bulletin of the World Health Organization, 2004
To assess the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. Secondary analysis was performed on nationally representative cross-sectional surveys of women in 16 developing countries. In the 16 countries, the median per cent of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that the majority of abortions and unwanted...
Journal of Family Planning and Reproductive Health Care, 2013
Objective To assess trends and determinants of family planning use and impact of HIV serostatus among couples. Methods Couples' data were retrospectively linked from cohort surveys in Rakai, Uganda between 1999 and 2011, and were classified by HIV status as concordant (M+F+/M−F−) or serodiscordant (M−F+/M+F−). HIV care (HIVC) was grouped into three periods, pre-antiretroviral therapy ( pre-HIVC) (<2004), HIVC roll-out (2005)(2006)(2007) and HIVC scale-up (≥2008). Trends in couple contraceptive use were assessed by chisquare test (χ 2 ) for trend, and multinomial logistic regression was used to estimate adjusted odds ratios (ORs) of predictors of contraceptive use. Results A toal of 6139 couples contributed 13 709 observations. Hormonal contraception (HC) use increased over time from 22.9% to 33.9%, p<0.001), with significant increases among M−F− (23.2% to 34.8%, p<0.0001) and M+F+ (20.8% to 32.2%, p=0.0005), but not serodiscordant couples. Condom use significantly increased among M+F+ (30.3% to 48.0%, p<0.001) and serodiscordant couples (24.2% to 48.7%, p<0.001), but not among M−F− couples. Dual use of HC and condoms increased over time, irrespective of HIV status. Factors associated with increases in contraceptive use were: higher education, co-resident children, male non-marital relationship and scaled-up HIVC phase. Enrolment into HIVC was associated with increased HC and condom use among HIV+ concordant [adjusted OR (adjOR)=3.03; 95% confidence interval (CI) 1. respectively], and serodiscordant couples (adjOR=2.21; 95% CI 1.25-3.92 and adjOR=4.75; 95% CI 2.89-7.82, respectively).
Dual contraceptive method use in HIV-serodiscordant Kenyan couples
The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, 2016
World Health Organization (WHO) guidelines recommend dual contraceptive method use with condoms and another contraceptive to reduce both incidence of HIV/sexually transmitted infection transmission and unintended pregnancies. This qualitative study assessed the barriers to and motivations for dual contraceptive use in Kenyan HIV-serodiscordant couples. HIV-serodiscordant couples in Nairobi, Kenya, were recruited from two longitudinal cohorts. Qualitative semistructured interviews were conducted using a semistructured questionnaire. Twelve male and 12 female members of serodiscordant couples and 10 women with incident pregnancies during the cohort studies were included. Few couples reported using dual contraceptive methods, with men reporting more condom use than women. No HIV-seropositive men or HIV-seronegative women reported using non-condom contraception. Men and women agreed that men play a dominant role in decisions to use both condoms and contraception in HIV-serodiscordant co...
A STUDY ON FAMILY PLANNING METHODS AMONG HIV SERO DISCORDANT COUPLES IN KARNATAKA
National Journal of Community Medicine, 2016
Introduction: India has third largest number of people living with HIV/AIDS in the world. Sero-discordance in couples refers to two people (One HIV positive and other negative) who are in ongoing sexual relationship in which both partners have tested for HIV and there has been full disclosure of HIV status. This study aims to understand planning methods and adherence to ART treatment among HIV sero-discordant couples in Karnataka. Methods: A cross sectional study was conducted in Karnataka from Apr to September 2015 .A total of 314 sero-discordant couples enrolled in PLHIV Networks for HIV care and support services in 4 sites of Karnataka were selected for the study . Results: Majority (79%) of sero-discordant couples have adopted sterilization method of contraception. The condom usage (12%) and copper-T(2%) methods were pretty low. Adherence to ART (≥ 95%) among sero-discordant couples was high at 94.6%. PLHIV with a spouse having higher educational status were better adher- ing to ART on comparison with spouse of lower educational sta- tus. This difference was statistically significant (P<0.01). Conclusion: The study shows that the HIV sero-discordant couples are using sterilization methods more in comparison to other family planning methods and are highly adherent to ART.
Reproductive health, 2016
Describe dual contraceptive method use and the intention to become pregnant of people living with HIV (PLHIV) and their partners in Thailand. From January 2008-March 2009, we systematically selected a cohort of PLHIV from PLHIV seeking care at five tertiary care hospitals and one community hospital to complete a questionnaire assessing sexual activity, intention to become pregnant, and contraceptive practices at baseline and 12 months after enrollment. Participants received short family planning messages every 2-3 months to promote the use of dual contraceptives and were offered family planning services. A total of 1,388 PLHIV enrolled, their median age was 37 years (IQR 33-43), 898 (64.7 %) had a steady partner, and 737 (53.1 %) were male. Among those with a steady partner, 862 (96.0 %) did not intend to become pregnant; 709 (82.3 %) had sex during the previous 3 months, 683 (96.3 %) used at least one contraceptive method, and 202 (29.6 %) used dual contraceptive methods. Of the 31...