Reproductive behaviour among women on antiretroviral therapy in Botswana: mismatched pregnancy plans and contraceptive use

  • Michelle M Schaan
  • Myra Taylor
  • Richard Marlink

Abstract

Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36), bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older, less educated, had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57–7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47–8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10–5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90%, a total of 26 of these women (34%) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this, coupled with the lack of control over condom use, puts unmet need for contraception at 38%. Most women reported feeling comfortable talking with HCWs about contraceptives. However, almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner.

Keywords: Pregnancy planning, contraceptive use, antiretroviral therapy, women living with HIV, unmet need for contraception

African Journal of AIDS Research 2014, 13(3): 305–311

Author Biographies

Michelle M Schaan
University of Kwazulu-Natal, Department of Public Health Medicine, 236 George Campbell Building, Howard College Campus, King George V Avenue, Durban, 4041 South Africa; Harvard School of Public Health AIDS Initiative, 651 Huntington Avenue, Boston, Massachusetts 02115, USA; Botswana-Harvard Partnership for HIV Research and Education, Princess Marina Hospital, North Ring Road, Gaborone, Botswana
Myra Taylor
University of Kwazulu-Natal, Department of Public Health Medicine, 236 George Campbell Building, Howard College Campus, King George V Avenue, Durban, 4041 South Africa
Richard Marlink
Harvard School of Public Health AIDS Initiative, 651 Huntington Avenue, Boston, Massachusetts 02115, USA; Botswana-Harvard Partnership for HIV Research and Education, Princess Marina Hospital, North Ring Road, Gaborone, Botswana
Published
2014-10-28
Section
Articles

Journal Identifiers


eISSN: 1608-5906
print ISSN: 1727-9445