The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey
Abstract Background Prevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contrace...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Contraception and Reproductive Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40834-023-00260-w |
| _version_ | 1797397673976791040 |
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| author | Saitoti Timoth Jane Machange Kilaye Karino Sally Mtenga Abdallah Mkopi Francis Levira |
| author_facet | Saitoti Timoth Jane Machange Kilaye Karino Sally Mtenga Abdallah Mkopi Francis Levira |
| author_sort | Saitoti Timoth |
| collection | DOAJ |
| description | Abstract Background Prevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contraceptives among HIV-positive women. This study aims to evaluate the success of a service integration strategy by comparing the prevalence of modern contraceptive use among HIV-positive women receiving ART within integrated services and those not on integrated services (HIV-negative women and HIV-positive women unaware of their status). Methods We used data from the Tanzania HIV impact survey (THIS) of 2016/17. THIS provided HIV counselling and testing with a return of results in over 30,000 adults over 15 years of age. Women tested positive self reported their enrollment into ARV with further confirmation through laboratory analysis for any detectible ARV in their blood. All non-pregnant women reported their contraceptive use. Univariate and multivariate logistic regression was used to assess the effect of accessing integrated services controlling for potential confounders. Results A total of 14,986 women were included in the analysis; HIV-positive women were 1,066 and HIV-negative women were 13,830. Modern contraceptive use prevalence was 35% among HIV-positive women and 30% among HIV-negative women. Among HIV-positive women, those enrolled in integrated services (ART) had a higher prevalence of modern contraceptive (40%) compared to HIV-positive women unaware of their status (27%, p-value = 0.0014). The most common contraceptive methods in HIV-positive women were injectables (32%) and male condoms (31%), while in HIV-negative women, injectables (39%) and implants (30%, n = 1032) were the most preferred methods. Among HIV-positive women, enrolment into integrated services (currently on ART) demonstrated an increase in the odds of modern contraceptives by 85% (AOD = 1.85, 95%CI: 1.27–2.71). Conclusion This study found relatively low modern contraceptive use among HIV-positive women in the general population despite the existance of service integration program and guidelines to guide its implementation.Our study therefore calls for the evaluation on the implementation of the integration programme to identify factors that constrain or facilitate programme effectiveness. |
| first_indexed | 2024-03-09T01:14:33Z |
| format | Article |
| id | doaj.art-540ce043924044e698972c4715755b5d |
| institution | Directory Open Access Journal |
| issn | 2055-7426 |
| language | English |
| last_indexed | 2024-03-09T01:14:33Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Contraception and Reproductive Medicine |
| spelling | doaj.art-540ce043924044e698972c4715755b5d2023-12-10T12:34:59ZengBMCContraception and Reproductive Medicine2055-74262023-12-018111210.1186/s40834-023-00260-wThe impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact surveySaitoti Timoth0Jane Machange1Kilaye Karino2Sally Mtenga3Abdallah Mkopi4Francis Levira5School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and TechnologySchool of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and TechnologyKilimanjaro Christian Medical University CollegeSchool of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and TechnologySchool of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and TechnologySchool of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and TechnologyAbstract Background Prevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contraceptives among HIV-positive women. This study aims to evaluate the success of a service integration strategy by comparing the prevalence of modern contraceptive use among HIV-positive women receiving ART within integrated services and those not on integrated services (HIV-negative women and HIV-positive women unaware of their status). Methods We used data from the Tanzania HIV impact survey (THIS) of 2016/17. THIS provided HIV counselling and testing with a return of results in over 30,000 adults over 15 years of age. Women tested positive self reported their enrollment into ARV with further confirmation through laboratory analysis for any detectible ARV in their blood. All non-pregnant women reported their contraceptive use. Univariate and multivariate logistic regression was used to assess the effect of accessing integrated services controlling for potential confounders. Results A total of 14,986 women were included in the analysis; HIV-positive women were 1,066 and HIV-negative women were 13,830. Modern contraceptive use prevalence was 35% among HIV-positive women and 30% among HIV-negative women. Among HIV-positive women, those enrolled in integrated services (ART) had a higher prevalence of modern contraceptive (40%) compared to HIV-positive women unaware of their status (27%, p-value = 0.0014). The most common contraceptive methods in HIV-positive women were injectables (32%) and male condoms (31%), while in HIV-negative women, injectables (39%) and implants (30%, n = 1032) were the most preferred methods. Among HIV-positive women, enrolment into integrated services (currently on ART) demonstrated an increase in the odds of modern contraceptives by 85% (AOD = 1.85, 95%CI: 1.27–2.71). Conclusion This study found relatively low modern contraceptive use among HIV-positive women in the general population despite the existance of service integration program and guidelines to guide its implementation.Our study therefore calls for the evaluation on the implementation of the integration programme to identify factors that constrain or facilitate programme effectiveness.https://doi.org/10.1186/s40834-023-00260-wReproductive womenHIV positiveHIV negativeModern contraceptive useTanzania |
| spellingShingle | Saitoti Timoth Jane Machange Kilaye Karino Sally Mtenga Abdallah Mkopi Francis Levira The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey Contraception and Reproductive Medicine Reproductive women HIV positive HIV negative Modern contraceptive use Tanzania |
| title | The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey |
| title_full | The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey |
| title_fullStr | The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey |
| title_full_unstemmed | The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey |
| title_short | The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey |
| title_sort | impacts of family planning and hiv service integration on contraceptive prevalence among hiv positive women in tanzania a comparative analysis from the 2016 17 tanzania hiv impact survey |
| topic | Reproductive women HIV positive HIV negative Modern contraceptive use Tanzania |
| url | https://doi.org/10.1186/s40834-023-00260-w |
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