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    Correlates of reported modern contraceptive use among postpartum HIV-positive women in rural Nigeria: An analysis from the MoMent prospective cohort study

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    Author
    Chinaeke, E.E.
    Fan-Osuala, C.
    Bathnna, M.
    Date
    2019
    Journal
    Reproductive Health
    Publisher
    BioMed Central Ltd.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1186/s12978-018-0663-8
    Abstract
    Background: Nigeria has an annual population of ~ 200,000 women who are both pregnant and HIV-positive. High unmet need for family planning in this population could lead to unintended pregnancies, along with the increased risk of mother-to-child transmission of HIV (MTCT). To identify modifiable barriers and facilitators in effective family planning, we examined correlates of modern contraceptive use among HIV-positive women enrolled in the MoMent prevention of MTCT (PMTCT) implementation research study in rural North-Central Nigeria. Methods: In this prospective cohort study, HIV-positive pregnant women were enrolled at 20 Primary Healthcare Centers and followed up to 12 months postpartum. Baseline socio-demographic, clinical and obstetric data were collected at enrollment. Participants were to receive routine family planning counselling from healthcare workers during postnatal visits. Analysis utilized baseline data linked to available family planning information collected from each woman at the first postpartum visit. Multivariate logistic regression was performed to determine factors associated with modern contraceptive use. Results: Out of 497 women enrolled, family planning data was available for 399 (80.3%) women, of whom 349 (87.5%) received family planning counselling, and 321 (80.5%) were 30 years old or less. Two-thirds (268, 67.2%) of the cohort analyzed had 1-2 children at baseline; 24.8% (n = 99) had 3-4 children, and 8.0% (n = 32) had > 4 children. Approximately half (199, 49.9%) of the women reported no modern contraceptive use in the postpartum period. Male condoms (116, 29.1%) were the most reported method of contraception; other methods reported included oral hormones (71, 17.8%) and intrauterine devices (13, 3.2%). Only disclosure of HIV status to male partner or relative (aOR = 2.0, 95% CI: 1.2-3.3; p = 0.01) and receipt of family planning counselling (aOR = 2.3, 95% CI: 1.1-4.8; p = 0.03) were positively associated with reported modern contraceptive use. Age, marital or educational status, religious affiliation, employment status, gravidity and parity were non-correlates. Conclusions: Family planning counselling and disclosure of HIV status are modifiable positive predictors of contraceptive use among our cohort of postpartum HIV-positive women in rural Nigeria. Rates of unintended pregnancy and concomitant risk of MTCT could be significantly reduced through strategies that facilitate these correlates. Clinical trials registration: Clinicaltrials.gov registration number: NCT 01936753; registered September 3, 2013. © 2019 The Author(s).
    Sponsors
    The MoMent Nigeria study was funded by the World Health Organization through an award for the INtegrating and Scaling up PMTCT through Implementation REsearch (INSPIRE) initiative from Global Affairs Canada. Neither WHO nor Global Affairs Canada were involved in the design of this study and collection, analysis, and interpretation of data and in writing this manuscript.
    Keyword
    Contraception behavior
    Contraceptive agents
    HIV
    Nigeria
    PMTCT
    Rural populations
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059795569&doi=10.1186%2fs12978-018-0663-8&partnerID=40&md5=7488734048dee64e1ce1c5359bd47a55; http://hdl.handle.net/10713/8633
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12978-018-0663-8
    Scopus Count
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    UMB Open Access Articles 2019

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