Unintended pregnancy among HIV-positive pregnant women in Enugu, southeast Nigeria.

OBJECTIVE: To determine the prevalence and factors associated with unintended pregnancy among HIV-positive pregnant women in Enugu, southeast Nigeria. METHODS: A questionnaire-based cross-sectional study was performed of HIV-positive pregnant women receiving prenatal care at two tertiary health institutions in Enugu between March 1 and August 31, 2012. The women were interviewed with a pretested questionnaire. RESULTS: Overall, 180 HIV-positive pregnant women were recruited, 67 (37.2%) of whom declared that their pregnancy was unintended. Overall, 174 (96.7%) patients were receiving antiretroviral therapy and 99 (55.0%) had future fertility intensions. Participants with regular partners (married or cohabiting) had a significantly higher rate of unintended pregnancy than those with unstable partners (40.3%, n=64/159 vs 14.3%, n=3/21 P=0.029). Age, parity, educational level, and current treatment with antiretroviral therapy did not significantly affect the prevalence of unintended pregnancy. CONCLUSION: A substantial number of HIV-positive pregnant women declared their pregnancies to be unintended. Modern contraceptives should be made readily available and accessible to HIV-positive women to help eliminate mother-to-child transmission of HIV and subsequent new pediatric HIV infections.

Contraceptive use among HIV-positive women in Enugu, southeast Nigeria.

OBJECTIVE: To determine the prevalence and pattern of, and factors associated with, contraceptive usage among HIV-positive women in Enugu, southeastern Nigeria. METHODS: In a questionnaire-based cross-sectional study, 400 consecutive HIV-positive, sexually active women receiving care at the adult HIV clinics of 2 tertiary health institutions in Enugu were interviewed using pre-tested questionnaires between March and August 2012. Descriptive and inferential statistical analysis was carried out via Epi Info. RESULTS: The rate of contraceptive use was 73.1%; 26.9% (n=91) of women were not using modern contraceptives. Male condoms were the most frequent contraception used (78.1%, n=193), but 48.2% of women reported inconsistent use. The proportion of women using a dual-contraceptive method was 25.1%; none used the female condom. Having a regular sexual partner was significantly associated with use of modern contraception (odds ratio, 73.00; 95% confidence interval, 34.13-156.13; P<0.001). Misconception and fear of adverse effects were the most common reasons for not using contraception. CONCLUSION: A considerable proportion of HIV-positive women in Enugu who did not desire to achieve pregnancy in the following 2 years (26.9%) had an unmet need for contraception. The use of contraception prevents unintended pregnancy and subsequent mother-to-child transmission of HIV and should be promoted in the region.