Correlates of contraceptive use among HIV discordant couples in Kenya

  • Kenneth Ngure Kenyatta National Hospital, Nairobi, Kenya
  • Zipporah Ng’ang’a Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University, Kenya
  • Violet Kimani School of PublicHealth, University of Nairobi, Kenya
  • Samoel Khamadi Center for Virus Research, Kenya Medical Research Institute, Kenya
  • Frankline Onchiri Center for Microbiology Research, Kenya Medical Research Institute, Kenya
  • Elizabeth Irungu Kenyatta National Hospital, Nairobi, Kenya
  • Renee Heffron Department of Epidemiology, University of Washington, Seattle, USA
  • Edwin Were School of Public Health, Moi University, Kenya
  • Nelly Mugo Department of Global Health, University of Washington, Seattle, USA
Keywords: Contraceptive use, HIV, discordant, Kenya, couples, women

Abstract

Despite risks of HIV transmission to infants born of the HIV positive women, contraceptive use is uncommon among women in HIV discordant partnerships. The aim of this study was to determine the factors associated with contraceptive use in a clinical trial cohort of HIV serodiscordant couples based in Thika and Eldoret, Kenya. Data were analyzed from 481 HIV discordant couples enrolled in the Partners in Prevention HSV/HIV Transmission Study at the Thika and Eldoret sites. The primary study outcome was self-reported use of contraception other than condoms. Using a marginal longitudinal logistic model based on generalized estimating equations (GEE) approach we assessed the association of various demographic and behavioral factors with contraceptive use. At baseline the prevalence of non barrier contraceptive use among HIV positive and negative women was 24.3% and 25.7%, respectively. At month 12 of follow-up, the prevalence of contraceptive use was 44.4% among the HIV positive and 26% among the HIV negative women while at month 24, the prevalence of contraceptive use was 38.6% among the HIV positive and 18.2% among the HIV negative women. HIV positive women were more likely to report using contraception than HIV negative women (odds ratio (OR) 1.61 95% confidence interval (CI) 1.04-2.47). Additionally, being married (OR 2.4, 95% CI 1.2-5.0), attending Thika site clinic (OR 6.1, 95% CI 4.2-9.0), and having two or more children (OR 1.9, 95% CI 1.3-2.8) were significantly associated with use of non barrier contraceptives. Future programs should focus on interventions to increase contraceptive use among HIV serodiscordant couples, with a special emphasis on HIV negative women, unmarried women and women with few children.
Published
2012-04-30
Section
Articles