ABSTRACT


Background: In Sub-Saharan Africa HIV/AIDS prevalence remains high and makes it the world’s most severely affected region. The use of family planning helps to prevent unplanned pregnancies among HIV positive women of reproductive age. There is a dearth of evidence on the preferred methods, reasons for use and non-use and discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Therefore this study was conducted to determine family planning uptake, methods preferred and the reasons for discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City.


Methods: This is a hospital based cross-sectional study involving 440 HIV positive reproductive age women (18 – 49 years) who were attending Bugando Medical Centre, Sekou Toure Regional Referral Hospital and Buzuruga Health Centre HIV Care and Treatment Clinics was carried out. A structured pre tested questionnaire was used to collect data on socio-demographic characteristics, information on current family planning use, health service related factors, family factors, disclosure and ART status, and factors associated with modern family planning use. Data analysis was done using STATA version 13 according to objectives.

Results: A total of 440 participants were enrolled in the study and their mean age was 36 [IQR 30 – 42] years. Majority, 246 (56.2%) of the participants were aged 35 to 49 years. Most, 279 (63.4%) of women attained primary education. Factors associated with family planning discontinuation were not been counseled on FP (AOR 5.5; 95% CI 2.0 – 15.1; p – value 0.001), Partner has no desire of children AOR 0.3; 95% CI 0.1 – 0.8;p-value=0.029), Advanced stage of HIV (AOR13.4; 95% CI 5.1 – 35.0; p –value<0.001 ), Divorced women (AOR 3.2; 95% CI 1.1 – 9.7; p-value=0.038) and women’s age ≥35 years (AOR 6.8; 95% CI 2.2 – 20.9 p-value=0.001).

Conclusion: The overall uptake of modern family planning methods was low. Integration of modern family planning services within the CTCs has not been implemented in all the facilities surveyed. Dual contraceptive utilization was strikingly low. A large proportion of HIV-positive reproductive age women discontinued FP. Women utilizing modern methods of family planning, preferred implant the most followed by condoms, injectable contraceptives, followed by those who underwent bilateral tubal ligation, combined oral contraceptives and intrauterine contraceptive devices respectively. Insist on consistence of uptake of modern FP and discourage discontinuation of FP.