UNMET NEED FOR CONTRACEPTION AMONG HIV-POSITIVE WOMEN ATTENDING HIV CARE AND TREATMENT SERVICE AT SPHMMC, ADDIS ABABA, ETHIOPIA
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BACKGROUND- Ethiopia is one of the nations severely affected by the HIV pandemic with a national adult HIV prevalence of 1.5% with women disproportionately affected than men (1.9% compared to 1.0% in men). Despite its demonstrable contribution, far less attention has been given to prevention of unintended pregnancy as a strategy to PMTCT.
OBJECTIVES- To determine the level and contributing factors of unmet need for contraception among HIV positive women in the ART care unit at SPHMMC.
METHODOLOGY-A facility based cross sectional study was conducted from September 1/2014-November 30/2014. An exit interview of sampled women enrolled at the ART clinic of SPHMMC was done using structured and pretested questionnaire. Descriptive, bivariate, and multivariate methods were used to analyze the level of unmet need and its contributing factors.
RESULTS- The overall unmet need for contraception was 25.1%. The most common reasons for non-use were related to perceived low risk of pregnancy. Unmet need was more common in unmarried women and those who did not discuss about contraception with HIV care provider. Making joint decision on contraceptive utilization with partner and having sero-discordant partner were associated with decreased odds of both overall unmet need and unmet need for dual contraceptive method.
CONCLUSION AND RECOMMENDATIONS- The ART clinic represented one of the missed opportunities to initiate and promote contraceptive use. Appropriate counseling to correct misconceptions and addressing the barriers to contraceptive use could improve contraceptive use. Integration of FP and other RH services with the general ART service can address the reproductive health needs of HIV positive clients. Revising training curriculum to ensure FP/HIV integration are covered in pre-service training is justified.