ABSTRACT
Voluntary counseling and testing (VCT) and HIV care (HIVC) can be an opportunity for reproductive health messages and services integration. The objective of this study is to assess the association between uptake of HIV-related services and use of modern contraception among reproductive-age women. Data are derived from community cohort data, where HIV+ respondents were referred to the Rakai Health Sciences program's HIVC clinic. Use of modern contraceptive and VCT receipt were by self-report. Multinomial logistic regression was used to estimate relative risk ratios (RRR) of contraception use by HIVC and VCT. Receipt of VCT was significantly associated with higher use of condoms for FP, adj.RRR 1.78 (1.07, 2.95), and other modern contraceptives, adj.RRR=1.56(1.15, 2.11). Increasing level of HIVC was associated with decreasing level of unmet need for contraception. Use of condoms for family planning is common among HIV-related services attendees. Utilization of other modern contraceptive methods needs to be increased (Afr J Reprod Health 2010; 14[4]: 91-101)
Subject(s)
Contraception , HIV Infections , Reproduction , Uganda , WomenABSTRACT
A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District; Uganda. Over a period of 30 months; women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condoms used increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39 year age group; married; better educated; and had higher parity than others; whereas women or men adopting condoms were predominantly young; unmarried; and better educated; and had higher parity than others; whereas women or men adopting condoms were predominantly young unmarried; and better educated. Condom use was tarticularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children; among those who wished to space or terminate childbearing; and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use; but HIV testing and counselling had only modest effects. Contraception for pregnancy prevention and for HIV/STD propylaxis are complementary
Subject(s)
HIV , Condoms , Contraception , Pregnancy , Rural HealthABSTRACT
The objective was to determine the incidence of infection which HIV-1 and the risk factors associated with seroconversion in three geographical strata of a rural Ugandan district. Design-Serological; sociodemographic; and behavioural surveys of everyone aged 13 or more in 21 randomly selected communities at baseline and one year later. Setting - Rural population of Rakai district; south-western Uganda; residing in main road trading centres; secondary trading villages; and agricultural villages. Subjects - In 1989; 1292 adults provided a blood sample and interview data; one year later; 778 survivors (77) who had been seronegative at baseline provided follow up data. Main outcome measures - Incidence of HIV infection in relation to individual characteristics and risk factors; including place of residence. The results showed that the incidence of HIV infection in all adults was 2.1/100 person years of observation (SE 0.5(95) confidence interval 1.1 to 3.1); in people aged 15-39 the incidence was 3.2/100 person years. Incidence was highest in men and women aged 20-24 (9.2/100 person years (3.9) and 6.8/100 person years (2.9) respectively). Risk factors significantly associated with seroconversion were age 24 and under and two or more sexual partners. Between the surveys the proportion of all respondents reporting high risk behaviour (two or more partners) significantly increased from 8.9to 12.3. Despite preventive programmes and substantial knowledge about AIDS the incidence of HIV infection remains high in this rural population. Prevention aimed at vulnerable rural communities is urgently needed to contain the HIV epidemic