Browsing by Author "Nakaye, Catherine"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Unintended pregnancy and contraception use among African women living with HIV: Baseline analysis of the multi-country US PEPFAR PROMOTE cohort
    (Public Library of Science, 2024-03-11) Aizire, Jim; Yende-Zuma, Nonhlanhla; Hanley, Sherika; Nematadzira, Teacler; Nyati, Mandisa M; Dadabhai, Sufia; Chinula, Lameck; Nakaye, Catherine; Fowler, Mary Glenn; Taha, Taha
    About 90% of unintended pregnancies are attributed to non-use of effective contraception-tubal ligation, or reversible effective contraception (REC) including injectables, oral pills, intra-uterine contraceptive device (IUCD), and implant. We assessed the prevalence of unintended pregnancy and factors associated with using RECs, and Long-Acting-Reversible-Contraceptives (LARCs)-implants and IUCDs, among women living with HIV (WLHIV) receiving antiretroviral therapy (ART). We conducted cross-sectional analyses of the US-PEPFAR PROMOTE study WLHIV on ART at enrollment. Separate outcome (REC and LARC) modified-Poisson regression models were used to estimate prevalence risk ratio (PRR) and corresponding 95% confidence interval (CI). Of 1,987 enrolled WLHIV, 990 (49.8%) reported their last/current pregnancy was unintended; 1,027/1,254 (81.9%) non-pregnant women with a potential to become pregnant reported current use of effective contraception including 215/1,254 (17.1%) LARC users. Compared to Zimbabwe, REC rates were similar in South Africa, aPRR = 0.97 (95% CI: 0.90-1.04), p = 0.355, lower in Malawi, aPRR = 0.84 (95% CI: 0.78-0.91), p<0.001, and Uganda, 0.82 (95% CI: 0.73-0.91), p<0.001. Additionally, REC use was independently associated with education attained, primary versus higher education, aPRR = 1.10 (95% CI: 1.02-1.18), p = 0.013; marriage/stable union, aPRR = 1.10 (95% CI: 1.01-1.21), p = 0.039; no desire for another child, PRR = 1.10 (95% CI: 1.02-1.16), p = 0.016; infrequent sex (none in the last 3 months), aPRR = 1.24 (95% CI: 1.15-1.33), p<0001; and controlled HIV load ([less than or equal to] 1000 copies/ml), PRR = 1.10 (95% CI: 1.02-1.19), p = 0.014. LARC use was independently associated with country (Zimbabwe ref: South Africa, PRR = 0.39 (95% CI: 0.26-0.57), p<0.001; Uganda, PRR = 0.65 (95% CI: 0.42-1.01), p = 0.054; and Malawi, aPRR = 0.87 (95% CI: 0.64-1.19), p = 0.386; HIV load ([less than or equal to] 1000 copies/ml copies/ml), aPRR=1.73 (95% CI: 1.26-2.37), p<0.001; and formal/self-employment, aPRR = 1.37 (95% CI: 1.02-1.91), p = 0.027. Unintended pregnancy was common while use of effective contraception methods particularly LARCs was low among these African WLHIV. HIV viral load, education, sexual-activity, fertility desires, and economic independence are pertinent individual-level factors integral to the multi-level barriers to utilization of effective contraception among African WLHIV. National programs should prioritize strategies for effective integration of HIV and reproductive health care in the respective African countries.
  • Thumbnail Image
    Item
    Viral Load suppression after intensive adherence counselling among HIV infected adults at Kiswa Health Centre, Kampala: A retrospective cohort study. Secondary data analysis
    (Research Square, 2022) Nakaye, Catherine; Mukiza, Nelson; Mawanda, Denis; Kataike, Hajira; Kaganzi, Hellen; Ahimbisibwe, Grace Miriam; Businge, Gerald Bright; Kyambadde, Raymonds Crespo; Nakalega, Rita
    The Joint United Nations Programme on HIV/AIDS through the 95-95-95 target requires 95% of people with HIV infection (PWHIV) on antiretroviral treatment (ART) to be virally suppressed. Viral Load (VL) non-suppression has been found to be associated with suboptimal ART adherence, and Intensive Adherence Counselling (IAC) has been shown to lead to VL re-suppression by over 70% in PWHIV on ART. Currently, there is data paucity on VL suppression after IAC in adult PWHIV in Uganda. This study aimed to evaluate the proportion of VL suppression after IAC and associated factors among adult PWHIV on ART at Kiswa Health Centre in Kampala, Uganda. Methods Study was a retrospective cohort design and employed secondary data analysis to review routine program data. Medical records of adult PWHIV on ART for at least six months with VL non-suppression from January 2018 to June 2020 at Kiswa HIV clinic were examined in May 2021. Descriptive statistics were applied to determine sample characteristics and study outcome proportions. Multivariable modified Poisson regression analysis was employed to assess predictors of VL suppression after IAC. Results Analysis included 323 study participants of whom 204 (63.2%) were female, 137 (42.4%) were between the age of 30 and 39 years; and median age was 35 years (interquartile range [IQR] 29–42). Participant linkage to IAC was 100%. 48.6% (157/323) of participants received first IAC session within 30 days or less after unsuppressed VL result. 66.78% (205/307) of participants who received recommended three or more IAC sessions achieved VL suppression. 34% of participants completed three IAC sessions in recommended 12 weeks. Receipt of three IAC sessions (ARR = 1.33, 95%CI: 1.16–1.53, p < 0.001) and having baseline VL of 1,000–4,999 copies/ml (ARR = 1.47, 95%CI: 1.26–1.73, p < 0.001) was significantly associated with VL suppression after IAC. Conclusion VL suppression proportion of 66.78% after IAC in this population was comparable to 70%, the percentage over which adherence interventions have been shown to cause VL re-suppression. However, timely IAC intervention is needed from receipt of unsuppressed VL results to IAC process completion. Resistance testing should be performed for PWHIV with persistent VL non-suppression after IAC for apt ART regimen switch.