Factors influencing utilization of modern family planning services by persons living with Human Immunodeficiency Virus at Luwero Hospital, Uganda

Introduction: The use of modern family planning methods is key for achieving the prevention of unintended pregnancies among women living with HIV, in the prevention of Mother-to-child transmission (PMTCT) package. The purpose of this study was to examine the factors influencing the utilization of modern family planning services by persons living with HIV at Luwero Hospital, Uganda. Methods: The study was conducted among 210 persons living with HIV attending the ART clinic and was based on cross-sectional descriptive and analytical design. Sampling was by simple random techniques. Data was collected using researcher-administered questionnaires. Results: The uptake of Modern FP services is low (36.7%) among persons living with HIV. It was attributed to client-related factors such as being married [AOR: 2.2, 95% CI [1.123-4.140], p = 0.038]) and other factors. These are; religious views discouraging use of modern FP (p= 0.034), negative side effects (AOR: 1.8, 95% CI [0.043-1.968], p = 0.044) and services being unfriendly for persons living with HIV (p=0.000]). Conclusions: Despite the presence of modern family planning services, uptake among persons living with HIV is low. Poor utilization is a recipe for unintended pregnancy and thus jeopardizes efforts in the elimination of mother-to-child transmission of HIV

Factors Associated with Failed Contraception in Women Attending Level One Hospitals in Lusaka, Zambia

Background: Unintended pregnancy is a major public health concern due to its impact on maternal morbidity and mortality. Contraceptive failure is one of the causes of unintended pregnancy. Data on factors associated with contraceptive method failure is scarce. This study therefore aimed to explore factors associated with contraceptive failure. Methodology: Unmatched case-control study was conducted at five Level One Hospitals in Lusaka. Convenience sampling was used to enrol 108 cases for whom pregnancy occurred while on a modern contraceptive method and 108 hospital-based controls who were on a modern contraceptive method and not pregnant. Binary and multiple logistic regressions were utilized for assessment of factors associated with failed contraception. Results: Among the 108 cases, 46 (42.6%), 40 (37%), 17 (15.7%) and 1 (0.9%) were on the oral contraceptive pill, injectable, implant and intrauterine device contraception methods respectively while 2 (1.9%) were on barrier and emergency contraceptive methods respectively. The odds of contraceptive failure when using the oral contraceptive pill was more than 7 times (AOR 7.790, 95% CI 1.210-50.161, p=0.031). Those who had contraception failure were more than 3 times more likely to be younger than 30 years old compared to those whose contraceptive method did not fail (AOR 3.559, 95% CI 1.100-11.521, p=0.034 and AOR 3.596, 95% CI 1.354-9.550, p=0.010 respectively for age groups 18-24 years and 24-30 years old). Other factors associated with higher odds of contraceptive failure were duration of marriage greater than one year, with the highest odds in those married for more than 10 years (AOR 9.744, 95% CI 2.232-42.537, p=0.002), higher social support (AOR 2.402, 95% CI 1.085-5.321, p=0.031), multiparity (AOR 15.299, 95% CI 3.034- 77.151, p=0.001), and duration of use of antecedent contraception method of more than 2-3 years (AOR 4.913, 95% CI 1.662-14.526, p=0.004). Conclusion: The oral contraceptive pill, younger age, marriage duration of more than one year and contraceptive use more than three years were associated with contraceptive failure. Good messaging and counseling on usage of the oral contraceptive pill are recommended.

Unplanned pregnancy among female students at universities in the Eastern Cape Province, South Africa

Unplanned pregnancy has adverse effects including unsafe and illegal abortions causing maternal morbidity and mortality. Despite the adverse impact of unplanned pregnancy on women's personal life, their families, and society, there is a dearth of knowledge on unplanned pregnancy in institutions of higher education and training in South Africa. As a result, the objective of this study was to assess unplanned pregnancy and underlying factors among unmarried female students in universities in Eastern Cape. This was a cross-sectional survey of 1269 unmarried female students from universities in Eastern Cape selected using multistage cluster sampling. The study found that the prevalence of unplanned pregnancy was 12.31%, Health Science student (AOR: 0.41, 95% CI [0.17, 0.99], p < 0.001) were less likely to experience unplanned pregnancy. Being financially supported by a family (AOR: 0.17, 95% CI: [0.07, 0.43], p< 0.001) and being aged less than or equal to 18 years during the first sexual intercourse (AOR: 6.32, 95% CI: [2.57, 15.54], p < 0.001) were associated with unplanned pregnancy. Rural residence (AOR=3.93; 95% CI: (1.21, 12.84), p <0.001), not using contraceptives (AOR=10.63; 95%CI: 5.29, 21.37, p < 0.001) and having divorced parents (AOR=1.99; 95%CI: 1.14, 3.94), p < 0.001) were associated with unplanned pregnancy compared to their counterparts, respectively. The prevalence of unplanned pregnancy is high among unmarried female students in universities in Eastern Cape. Unplanned pregnancy was influenced by age at first sexual intercourse, non-use of contraceptives, divorced parents, the field of study, and the source of financial support. Universities and stakeholders should work together to support reproductive health programmes to prevent unplanned pregnancy. (Afr J Reprod Health 2022; 26[7]: 29-37).

Racing risk, gendering responsibility: a qualitative study of how South African students talk about sexual risk and responsibility

Individuals' perceptions of risk have implications for whether and how they engage with protective strategies. This study investigated how sexual risk; specifically HIV and pregnancy and responsibility for these risks were constructed in discussions across five groups of youth in KwaZulu-Natal; South Africa. The qualitative study used focus groups and interviews with a sample of 28 tertiary level students and 7 peri-urban youth. The constructions of risk intersected with raced and gendered narratives around sexual risk and responsibility. These constructions were used by the participants to assign and displace responsibility for the risks of HIV and pregnancy; rendering some groups immune to these risks. This constitutes a form of stigmatisation and also has implications for participants' prevention practices