Reproductive behaviour among women on antiretroviral therapy in Botswana: Mismatched pregnancy plans and contraceptive use

Michelle M. Schaan, Myra Taylor, Richard Marlink

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36), bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older, less educated, had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57-7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47-8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10-5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90%, a total of 26 of these women (34%) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this, coupled with the lack of control over condom use, puts unmet need for contraception at 38%. Most women reported feeling comfortable talking with HCWs about contraceptives. However, almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalAfrican Journal of AIDS Research
Volume13
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Botswana
Reproductive Behavior
Contraceptive Agents
Pregnancy
Condoms
Contraception
Therapeutics
Unwanted Pregnancies
Stereotyping
Delivery of Health Care
Multivariate Analysis
HIV
Unplanned Pregnancy
Ambulatory Care
Emotions

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Virology

Keywords

  • Pregnancy planning
  • antiretroviral therapy
  • contraceptive use
  • unmet need for contraception
  • women living with HIV

Cite this

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abstract = "Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36), bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older, less educated, had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57-7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47-8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10-5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90{\%}, a total of 26 of these women (34{\%}) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this, coupled with the lack of control over condom use, puts unmet need for contraception at 38{\%}. Most women reported feeling comfortable talking with HCWs about contraceptives. However, almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner.",
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Reproductive behaviour among women on antiretroviral therapy in Botswana : Mismatched pregnancy plans and contraceptive use. / Schaan, Michelle M.; Taylor, Myra; Marlink, Richard.

In: African Journal of AIDS Research, Vol. 13, No. 3, 01.01.2014, p. 305-311.

Research output: Contribution to journalArticle

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