[Accepted Manuscript] HIV/AIDS and contraceptive use: Factors associated with contraceptive use among sexually-active HIV-positive women in Kenya
Magadi, M.A.;
Magadi, W.A.;
(2016)
[Accepted Manuscript] HIV/AIDS and contraceptive use: Factors associated with contraceptive use among sexually-active HIV-positive women in Kenya.
Contraception.
ISSN 0010-7824
DOI: https://doi.org/10.1016/j.contraception.2016.10.013
(In Press)
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With increased availability of anti-retroviral therapy and improved survival for people living with HIV, more HIV-positive women are leading full reproductive lives. However, HIV-positive women have special contraceptive needs/concerns. This paper examines the individual and community-level HIV/AIDS factors associated with contraceptive use and compares predictors of contraceptive uptake between HIV-positive and HIV-negative women in Kenya.
The study is based on secondary analysis of cross-sectional data of a sample of 9132 sexually-active women of reproductive age from the Kenya Demographic and Health Surveys collected in 2003 and 2008. Multilevel logistic regression models are used to examine individual and contextual community-level factors associated with current contraceptive use.
The study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities. It further reveals striking differences in factors associated with contraceptive uptake between HIV-positive and HIV-negative women. Education and the desire to stop childbearing are strongly associated with contraceptive uptake among uninfected women, but both factors are not significant among HIV-positive women for whom wealth is the most important factor. While HIV-negative women in the richest wealth quintile are about twice as likely to use contraceptives as their counterparts of similar characteristics in the poorest quintile, this gap is about seven-fold among HIV-positive women.
These findings suggest that having the desire and relevant knowledge to use contraceptives does not necessarily translate into expected contraceptive behavior for HIV-positive women in Kenya and that poor HIV-positive women may be particularly in need of increased access to contraceptive services.