Determinants of Contraceptive Choices among HIV Positive Women of Reproductive Age Attending Comprehensive Care Centre at Kitale County Referral Hospital, Kenya

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Cheruiyot, Edward Kiplagat
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Kenyatta University
Family planning is an important aspect of primary health care. In order to improve the efficacy of available contraceptive methods, it is of importance to identify factors influencing women’s choice of contraception. In Kenya, like many other sub-Saharan countries, prevention of unintended pregnancies among HIV positive women as a strategy for PMTCT has been neglected. This has resulted in a large population of HIV positive women who have a substantial degree of unmet need for family planning, estimated at 60% in the 2007 Kenya Aids Indicator Survey. This study focused on exploring the various determinants of contraceptive choices among HIV positive women of reproductive age seeking services at comprehensive care centre, Kitale County Referral hospital, Trans Nzoia County. The specific objectives for this study were to determine the knowledge levels, to determine the types of modern contraception used and to assess the factors that influence contraceptive choices among HIV positive women of reproductive age attending comprehensive care centre at Kitale County Referral Hospital. This was a cross-sectional descriptive study of 357 randomly selected HIV positive women where both quantitative and qualitative information was collected. The research instruments used were a questionnaire, key informant interview guide and a focus group discussion guide. The data was analyzed using Statistical Package for Social Sciences (SPSS V.20). Statistical techniques including Chi square, and logistic regression were used in the analysis. P<0.05 was considered significant. The findings showed that more than half of HIV positive women 182 (52.1%) were using hormonal modern contraceptives. Controlling for occupation, age, religion, access to contraceptives and facing challenges were significant determinants of contraceptive choice (p<0.05). Those below 30 years were less likely to choose non-hormonal contraceptives compared to those 30 years and above (OR; 95%CI: 0.341; 0.195-0.598). Those affiliated with catholic religion were 2 times more likely to choose non hormonal contraceptives compared to Protestants (OR; 95%CI: 2.226; 1.192-4.158). Those accessing contraceptive at the CCC were 11 times more likely to choose non-hormonal contraceptives compare to those accessing from other places (OR; 95%CI: 11.265; 2.914-43.551). Those experiencing challenges in accessing contraceptives were 6 times more likely to choose non-hormonal contraceptives compared to those not (OR; 95%CI: 6.246; 1.410-27.673).In conclusion,choice of contraceptive was strongly related to age, religion, access and challenges. There is need for the Governmental and nongovernmental organizations, health facilities and other stakeholders to ensure availability, accessibility and sustained advocacy for use of appropriate contraceptive methods. This will guarantee contraceptive commodity security and sustained demand for contraception among HIV positive women of reproductive age. There is also need for researchers to investigate husbands’ perception and acceptance towards contraceptive use by their partners
A thesis submitted in partial fulfilment of the requirements for the award of the degree of master of public health (reproductive health) in the school of public health of Kenyatta University, March 2016