Knowledge and correlates of use of safer conception methods among HIV-infected women attending HIV care in Uganda
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Date
2019
Authors
Gwokyalya, Violet
Beyeza-Kashesya, Jolly
Bwanika, John B.
Matovu, Joseph K. B.
Mugerwa, Shaban
Arinaitwe, Jim
Kasozi, Dickson
Bukenya, Justine
Kindyomunda, Rosemary
Wagner, Glenn J.
Journal Title
Journal ISSN
Volume Title
Publisher
Reproductive health
Abstract
Many people living with HIV would like to have children but family planning (FP) services often focus
on only contraception. Availability of safer conception services is still very low in most low income countries. In this
study we assessed the knowledge and use of safer conception methods (SCM) among HIV infected women in HIV
care in Uganda to inform integration of safer conception in existing FP services.
Methods: Data were accrued from a nationally representative cross-sectional survey of 5198 HIV+ women aged 15–
49 years from 245 HIV clinics in Uganda. Knowledge and use of safer conception methods and associated factors
were determined. The measure of association was prevalence ratio (PR) with corresponding 95% confidence
intervals, obtained using a modified Poisson regression via generalized linear models. All the analyses were
conducted using STATA version 12.0.
Results: Overall knowledge of any safer conception method was 74.1% (3852/5198). However only 13.2% knew 3
to 4 methods, 18.9% knew only 2 methods and 42% knew only one method. Knowledge of specific SCM was
highest for timed unprotected intercourse (TUI) at 39% (n = 2027) followed by manual self-insemination (MSI) at
34.8% (n = 1809), and pre-exposure prophylaxis (PrEP) at 24.8% (n = 1289). Knowledge of SCM was higher in the
Eastern region (84.8%, P < 0.001), among women in HIV-discordant relationships (76.7%, p < 0.017), and those on
ART (74.5%, p < 0.034). Overall, 1796 (34.6%) women were pregnant or reported a birth in the past 2 years—overall
use of SCM in this group was 11.6% (209/1796). The odds of use of SCM were significantly lower in Kampala [adj.
PR = 0.489(0.314, 0.764)] or Eastern region [adj.PR = 0.244; (0.147, 0.405)] compared to Northern region. Higher odds
of SCM use were associated with HIV status disclosure to partner [adj.PR = 2.613(1.308, 5.221)] and sero-discordant
compared to HIV+ concordant relationship [adj.PR = 1.637(1.236, 2.168)]. Pre-existing knowledge of any one SCM
did not influence SCM use.
Description
Keywords
Safer conception methods, Knowledge, HIV, Uganda, Reproductive health
Citation
Gwokyalya, V., Beyeza-Kashesya, J., Bwanika, J. B., Matovu, J. K., Mugerwa, S., Arinaitwe, J., ... & Wanyenze, R. K. (2019). Knowledge and correlates of use of safer conception methods among HIV-infected women attending HIV care in Uganda. Reproductive health, 16(1), 1-15.https://doi.org/10.1186/s12978-019-0717-6