Family Planning Among Hiv Positive And Negative Clients In A Resource Poor Setting In South Africa
Objective: To investigate family planning needs, knowledge of HIV transmission and HIV disclosure in a cohort sample that had undergone PMTCT in a resource poor setting. Design. Cross-sectional survey. Setting: Five clinics implementing PMTCT from Qaukeni Local Service Area, O.R. Tambo District in the Eastern Cape. Subjects: The sample at postnatal care consisted of one postnatal interview (n= 1310) when the infants were aged three months or less (n= 141, 10.8%), 4-6 months (n=200, 15.3%), 7-12 months (n=785, 59.9%), or 13-18 months (n=183, 14.0%). Results: One hundred and sixteen women were found HIV positive, 642 HIV negative and 552 with unknown HlV status. Considering those with HIV test results, 15.3% were HIV positive. Almost four out of five women got counselling on safe sex during pregnancy but only two out of three women practiced safe sex during pregnancy. Postnatally, almost all women received counselling on family planning, yet use of contraceptives and condoms were low. HIV positive women used condoms more often than HIV negative women. HIV positive women were significantly more likely than HIV negative women to say that they did not intend to have more children. For HIV positive women PMTCT knowledge was a positive predictor for the intention to have a child, while age, having a partner, HIV disclosure to partner and number of children were not significant. Pregnancy desire did not differ between HIV positive and HIV negative women regarding marital status, having two or more live births and HIV disclosure. Conclusion: High pregnancy desires, low contraceptive and condom use were found among HIV positive women. The incorporation of HIV prevention into promotion of contraceptives by family planning programmes and service providers needs to be improved.
East African Medical Journal Vol. 85 (3) 2008: pp. 20-27