scholarly journals The Level of Unmet Need for Family Planning and Its Predictors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Maru Mekie ◽  
Dagne Addisu ◽  
Wubet Taklual ◽  
Abenezer Melkie

Background. Studies indicated that the need for family planning appears to be greater for human immuno-deficiency virus- (HIV-) positive women than the general population to reduce the risk of pediatrics HIV infection and related consequences of unintended pregnancy. We aimed to assess the level of unmet need for family planning and its predictors among HIV-positive women in Ethiopia. Methods. Online databases such as PubMed, SCOPUS, EMBASE, HINARI, Google Scholar, and digital libraries of universities were used to search for studies to be included in this systematic review and meta-analysis. Quality assessment of included studies was conducted using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using the format prepared on Excel workbook and analyzed by the Stata 11 software. Cochran ( Q test) and I 2 test statistics were used to assess the heterogeneity of studies. Similarly, the funnel plot and Egger’s regression asymmetry test were used to assess publication bias. Result. This systematic review and meta-analysis was conducted using nine primary studies with a total of 6,154 participants. The pooled prevalence of unmet need for family planning among HIV-positive women was found to be 25.72% (95% CI: 21.63%, 29.81%). Participants age 15-24 years (( OR = 3.12 ; 95% CI: 1.59, 6.11) I 2 = 27.5 %; p = 0.252 ), being illiterate (( OR = 2.69 ; 95% CI: 1.69, 4.26) I 2 = 0.0 % ; p = 0.899 ), failure to discuss FP with partner (( OR = 3.38 ; 95% CI: 2.20, 5.18) I 2 = 0.0 %; p = 0.861 ), and no access to family planning information (( OR = 4.70 ; 95% CI: 2.83, 7.81) I 2 = 0.0 %; p = 0.993 ) were found to be a significant predictors of unmet need for family planning among HIV-positive women. Conclusion. The level of unmet need for family planning among HIV-positive women was found to be high in Ethiopia. Being young age, illiteracy, failed to discuss family planning issues with a partner, and no access to family planning information were found to be the significant predictors of unmet need for family planning among HIV-positive women in Ethiopia. Improving information access and encouraging partners’ involvement in family planning counseling and services could reduce the level of unmet need for family planning.

2020 ◽  
pp. 152483802090656 ◽  
Author(s):  
Eric Y. Tenkorang ◽  
Michael Asamoah-Boaheng ◽  
Adobea Y. Owusu

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.


2009 ◽  
Vol 41 (2) ◽  
pp. 269-278 ◽  
Author(s):  
TIMOTHY ADAIR

SummaryIn Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Getnet Gedefaw ◽  
Adam Wondmieneh ◽  
Asmamaw Demis

Background. Preventing unintended pregnancies among HIV positive women has a vital role to prevent mother to child transmission. Besides, increasing access to contraceptives has a number of economical importance and reducing the costs for mitigating the unintended pregnancy consequences. Therefore, this study is aimed at assessing the contraceptive use and method of preference among HIV positive women in Ethiopia. Methods. A systematic review and meta-analysis reporting guideline was applied. Articles searched from the Scopus, Pubmed/MEDLINE, EMBASE, AJOL, Hinari, and Google scholar were included in this review. The Stata 11 software was used to compute the analysis. Heterogeneity of the studies was detected using the Cochran Q test and I2 test statistics. Egger’s test was used to check the evidence of publication bias within the studies. Subgroup analysis and sensitivity analysis was computed with the evidence of heterogeneity. Results. Ten thousand one hundred twenty one (10121) women living with HIV/AIDS were recruited in this study. The national estimated prevalence of contraceptive use among HIV positive women in Ethiopia was 57.78% (95% CI: 48.53-67.03). Injectables and male condom were the most preferred contraceptives accounted for 36.00% (95% CI: 6.64-45.35) and 32.74% (95% CI: 21.08-44.40), respectively. Discussion with husband/partner (AOR: 4.70, 95% CI: 2.18-10.12), disclosure of HIV status to spouse/partner (AOR: 2.18, 95% CI: 1.55-3.06), ever counseled for modern contraceptives (AOR: 2.79, 95% CI: 2.01-3.88), attending secondary and above education (AOR: 3.12, 95% CI: 2.15-4.51), and having more than one live child (AOR: 2.61, 95% CI: 1.86-3.66) were increasing the likelihood of contraceptive use whereas not currently married women (AOR: 0.23, 95% CI: 0.16-0.34) was decreases the odds of contraceptive use. Conclusion. In Ethiopia, more than half of the women living with HIV/AIDS were using contraceptives. Discussion with husband/partner, disclosure of HIV status to spouse/partner, ever counseled for modern contraceptives, attending secondary and above education, and having more than one live child were increasing the uptake of contraceptives among HIV positive women. Partner discussion, having adequate information towards contraceptive use, and having desired number of child could increase the utilization; as a result, obstetric complication with HIV positive women due to unintended pregnancy is significantly decreasing.


2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Dennis Odai Laryea ◽  
Yaw Ampem Amoako ◽  
Kathryn Spangenberg ◽  
Ebenezer Frimpong ◽  
Judith Kyei-Ansong

Author(s):  
A. Mohammed ◽  
D. Chiroma ◽  
C. H. Laima ◽  
M. A. Danimoh ◽  
P. A. Odunze

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care. Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic. Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832). Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.


PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0163965 ◽  
Author(s):  
Sonia Menon ◽  
Aibibula Wusiman ◽  
Marie Claude Boily ◽  
Mbabazi Kariisa ◽  
Hillary Mabeya ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255566
Author(s):  
Bereket Kefale ◽  
Bezawit Adane ◽  
Yitayish Damtie ◽  
Mastewal Arefaynie ◽  
Melaku Yalew ◽  
...  

Background Closing the gap of unmet for family planning is crucial to eliminate new pediatric HIV infections likewise to improve maternal and child health among reproductive-age women living with HIV. However, studies conducted on unmet need for family planning among reproductive-age women living with HIV showed inconsistent and non-conclusive findings on the magnitude of the problem. Moreover, there was no meta-analysis conducted in this area. So this systematic review and meta-analysis were conducted to estimate the pooled prevalence unmet need for family planning among reproductive-age women living with HIV in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review both published and unpublished studies in Ethiopia. All studies in PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health databases were searched. Meta-analysis was performed using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger regression asymmetry test, respectively. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI). Results This review included 7 studies, and 3333 study participants. The pooled prevalence of unmet need for family planning among reproductive-age women living with HIV in Ethiopia was 25.13% (95%CI: 19.97, 30.29). The pooled prevalence of unmet need for spacing and limiting was 13.91% (95%CI: 10.11, 17.72) and 9.11% (95%CI: 6.43, 11.78), respectively. Conclusions One-fourths of reproductive-age women living with HIV had an unmet need for family planning. A variety of programmatic investments are needed to achieve more meaningful progress toward the reduction of unmet need for family planning among reproductive-age women living with HIV.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250297
Author(s):  
Hiwot Dejene ◽  
Muluemebet Abera ◽  
Afework Tadele

Background Unmet need for family planning is a measure of the gap between women’s contraceptive behavior and their fertility desires. It should be measured among different population groups to effectively implement public health interventions. Thus, this study aimed to determine the magnitude of unmet need for family planning and associated factors among HIV- positive women in Dire Dawa city Anti-retroviral treatment (ART) clinics, Eastern Ethiopia. Methods We carried out a facility-based cross-sectional study (March-June 2020) among 409 married women aged 15–49 on ART, using systematic random sampling. A face-to-face interview was done using a structured questionnaire. Bivariable and multivariable logistic regression was done to identify factors associated with unmet need for family planning. Results Overall, 33% [95% confidence interval (CI): 28.9–37.9] of the respondents had unmet need for family planning. Woman’s residing in a rural area (adjusted odds ratio (AOR): 2.41 [95% CI: 1.24–4.67]), woman’s not attained formal education (AOR: 4.14 [95% CI: 1.73–9.93]) and attaining primary education (AOR: 2.97 [95% CI: 1.54–5.74]), poor knowledge (AOR: 2.87 [95% CI: 1.52–5.40]), and unfavorable attitude towards family planning (AOR: 2.21 [95% CI: 1.12–4.34]), clients not satisfied with family planning service (AOR: 6.34 [95% CI: 3.31–12.15]), the woman not having decision making power on family planning (AOR:3.97 [95% CI: 2.14–7.38]) and not getting family planning counseling in ART clinics (AOR: 2.87 [95% CI: 1.54–5.35]) were positively associated with having unmet need for family planning. Conclusion This study indicates there a high unmet need for family planning among married HIV-positive women. Factors like a place of residence, educational status of women, knowledge and attitude towards family planning, client satisfaction with FP service, women decision-making power, and FP counseling service in ART. Therefore, we recommend that the concerned bodies should collaborate with ART clinics to design interventions that enhance access to family planning programs to combat the high unmet need for family planning among HIV-positive women.


2019 ◽  
Vol 8 (1) ◽  
pp. 54-62
Author(s):  
Alicia E. Hersey ◽  
Betty Norman ◽  
Rebecca Reece

Background or Objectives: HIV-positive women have higher rates of unmet need for contraception and unintended pregnancy and face unique obstacles in accessing family planning services, such as healthcare- related stigma and disclosing HIV status to partners. This study characterizes factors that influence the reproductive decision-making of women living with HIV and identifies areas for improvement in reproductive counseling in Kumasi. Methods: In this cross-sectional study, HIV-positive women, ages 18 to 45 years, presenting for care at Komfo Anokye Teaching Hospital between June and August 2017 were interviewed using structured surveys. Information gathered included demographics, method of contraceptive use, initiation of anti- retroviral therapy (ART), knowledge and use of contraception, and future reproductive plans. The primary outcome was current family planning use and future reproductive desire. Univariate analysis was used to characterize the demographics of the study group. Bivariate analysis including Chi-squared test was employed to assess the association between use of family planning between women with an HIV-positive and HIV-negative partner, with significance set at p < 0.05. Results: A total of 88 women were interviewed. The unmet need for contraception was 10%. Among all sexually active women, 26% did not use contraception. Fewer women with HIV-negative or untested partners were using contraception (65% and 67%, respectively), compared to women with HIV-positive partners (93%). Partner preference was the most common reason cited for not using a method of contraceptive (46%). Similar trends were found in future reproductive desires based on age cohorts, partner status, and use of family planning. Conclusion and Global Health Implications: Significant barriers to family planning use among HIV- positive women remain, especially those with a serodiscordant partner. Most partners were aware of their partner’s HIV status. This highlights an important opportunity to include partners in HIV and contraceptive counseling. Key words: • HIV • Family planning • Contraception • LARC • Serodiscordant • Ghana • Africa   Copyright © 2019 Hersey et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Alemu Degu Ayele ◽  
Bekalu Getnet Kassa ◽  
Fentahun Yenealem Beyene ◽  
Dagne Addisu Sewyew ◽  
Gedefaye Nibret Mihretie

Abstract Background Dual contraceptive is the use of a barrier like condom along with any modern contraceptive methods which has double significance for the prevention STI including HIV and unintended pregnancy. The prevalence and determinants of dual contraceptive utilization described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of dual contraceptive utilization among HIV positive women in Ethiopia. Methods International database mainly Pub Med, Google scholar, HINARI, EMBASE, Cochrane Library, AJOL was applied to identify original studies. STATA software version 14 was applied to analyze the pooled prevalence of dual contraceptive. I2 test statistics was computed to check the presence of heterogeneity across the studies and eggers test was used to identify publication bias. The pooled prevalence of dual contraceptive utilization was estimated by using a random effects model. The associations between determinants and dual contraceptive utilization were evaluated by using both random and fixed effect models. Result A total 9 studies with 9168 HIV positive women were enrolled in this study. The pooled prevalence of dual contraceptive utilization among HIV positive women in Ethiopia was 26.14% (95% CI 21.20–31.08). Disclosure of HIV status (OR = 4.18,95%CI:2.26–7.72), partner involvement in post-test counselling (OR = 2.31,95%CI:1.63–3.25), open discussion about dual contraceptive with partner (OR = 4.27 95% CI:1.69–10.77), provision of counselling on dual contraceptives by health care provider (OR = 4.47,95% CI:3.81–5.24) and CD4 count > 350 cells/ mm3 (OR = 3.87,95%CI:3.53–4.23) were among the significant factors associated with dual contraceptive utilization. Conclusion The overall prevalence of dual contraceptive utilization among HIV positive women was significantly low. Disclosure of HIV status, partner involvement in post-test counselling, open discussion about dual contraceptive with partner, counselling on dual contraceptive by health care provider and CD4 count > 350 cells/ mm3 were positively affect dual contraceptive utilization. This study implies the need to develop plans and policies to improve partner involvement posttest counseling, integrate the counseling and provision of dual contraceptive at ART clinic at each level of health system.


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