The role of hormonal contraceptives in HIV infection among antenatal mothers in Machakos District Hospital, Kenya
Matheka, Emmah Kanini
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Fighting Acquired Immune Deficiency Syndrome (AIDS) effectively requires a well targeted evidence based approach. Recent studies show that campaigns to prevent the spread of Human Immune-deficiency Virus (HIV) have focused on the promotion of abstinence, condom use, reduction on the number of sexual partners and treatment of Sexually Transmitted Infections (STIs). However, the incidence of HIV infection continues to rise in most of the regions. About 150 million women worldwide use hormonal forms of contraception in an effort to plan their families in order to control the modern population explosion. Many of them are at risk of being infected by HIV since 80% of' its transmission is through heterosexual behavior. Unlike barrier methods of contraception, hormonal methods offer no protection against STIs including the incurable and the dreaded HIV. Most prevalence studies on HIV have shown a higher general prevalence among sexually active women compared to their male counterparts. This gender difference can be associated with many biological and socio-cultural factors. Among the biological factors, the association between hormonal contraceptives and HIV infection has recently become a public health concern. This is because some studies have shown that hormonal contraceptives cause thinning of the vaginal and cervical mucosa, possibly increasing the likelihood of trauma and increasing the density of HIV target cells in an event of exposure to HIV infection. On the contrary, some other studies found no association between hormonal contraceptives and HIV acquisition. An association between hormonal contraceptives and HIV infection is of importance particularly given the need to control the rate of population growth in developing countries. The main objective of this study was to determine the relationship between use of hormonal contraceptives and susceptibility to HIV among women since the past few studies on this subject have yielded inconclusive results. Other study variables were analyzed against HIV status. This included socio-demographic information, sexual -reproductive and blood transfusion history among the study participants. The study was done in Machakos General Hospital as a cross-sectional study among the antenatal mothers visiting the antenatal clinic. It was incorporated in an ongoing programme of Prevention of Mother To Child Transmission of HIV (PMTCT). Data was managed using Statistical Package of Social Studies (SPSS) and Epi INfo. The results didn't show any significant evidence of association between hormonal contraceptives and the risk of HIV acquisition x2=0.01, ldf p³0.05 and OR of 1). However, significant relationships between some sociodemographic variables and HIV status among the study participants were found. This included, the residential area, type of occupation done by the respondents at the time of the study, among others. The results will be disseminated to the Kenyan Ministry of Health for appropriate action. This is mainly in enhancing family planning counseling on appropriate contraceptive methods. The results are also expected to help in clarification of previous results on this issue and to allay AIDS related fears among hormonal contraceptive users.