| dc.description.abstract | Introduction: Unintended pregnancy among HIV positive women remains a significant public health and in particular reproductive health concern. The health effects and drug interaction among the women on ART could have significant influence on unintended pregnancy.
Objective: To investigate factors associated with unintended pregnancy among HIV positive women on anti-retroviral therapy in Gulu District.
Methods: The study used facility based analytical cross sectional study design. Sample size was determined using Kish Leslie’s formula (1967) Data was collected using questionnaires among 200 women on ART from 4 ART clinics. Three research assistants were recruited and trained to collect data. The women on ART were sampled using Stratified sampling and purposive techniques. Consent was obtained before data collection. Data were entered into MS Excel 2010
for cleaning and exported into SPSS version 20 for statistical analysis at 95% Confidence Interval. Numerical data were computed and categorical data were analyzed and presented in pie-chart and tables. Overall, data were analyzed at Univariate, bivariate and multivariate levels. At Bivariate level, chi-square was used but Fisher’s exact test was used each time a cell (s) has value(s) less than 5. For all independent variables with significant difference with dependent variable, simple logistic was performed (Unadjusted Odds Ratios). Thereafter, multivariate logistic regression analysis (Adjusted Odds Ratios) was conducted and stepwise backward elimination modeling was undertaken to remove confounders during repeated analysis.
Results: Overall 200 HIV positive women on ART were studied. Mean age was 33 ±5.8 years; the median age was 33 years. Nearly half 94(47%) were aged 32-38 years, 136(68%) were married, 108(54%) completed primary education and 134(67%) had less or four children.
Prevalence of unintended pregnancy was 43% (n=86 N=200 CI: 0.36-50.17). Bivariate results showed that occupation (p=0.001), level of education (p<0.001), income class (p<0.001), number of children (p<0.001), having polygamous partner (p=0.003), history of abortion (p=0.038), using hormonal contraceptives before pregnancy realization (p=0.002), duration without contraceptive
before current pregnancy (p=0.002), contraceptive use before current pregnancy (p=0.036), specific types of contraceptive used (p<0.001), receiving FP and ARVs in single facility (p<0.001), transport cost to facility (p=0.003), duration on ART(P<0.001) had statistically
significant difference with unintended pregnancy. On adjusting for confounders using multivariate logistic regression, business women (AOR=0.018, CI: 0.04-0.74, p=0.017) and employed women (AOR=0.06, CI:0.01-0.29, p=0.001), secondary education (AOR=0.01 CI:0.00-
0.13, p=0.001), duration without contraceptive use (AOR=0.07 CI:0.02-0.31, p=0.001), Not receiving FP methods and ART from same facility (AOR=11.1, CI:3.78-32.59, p<0.001) and duration on ART 2-5 years (AOR=3.61, CI:1.75-37.44, p<0.001) and >5 years (AOR=12.91, CI:
4.45-37.44, p<0.001) had significant association with unintended pregnancy among women on ART.
Conclusion: Prevalence of unintended pregnancy was unacceptable at 43%. Business occupation, attaining secondary education, duration without contraceptive had reduced likelihood of unintended pregnancy. On the other hand, not receiving FP and ART from same facility, duration on ART significantly increased prevalence of unintended pregnancy. Health care providers should encourage girl child education and productivity through business training and practice and using at least two contraceptives by women on ART. Women should be encouraged to seek FP and ART in a single facility to facilitate detailed monitoring and studies to focus on reducing effect related to duration of being on ART among women on contraceptives. | en_US |
