Abstract
Objectives
With increased availability of antiretroviral 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.
Study design
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.
Results
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 sevenfold among
HIV-positive women.
Conclusion
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.
Implications
• Study provides evidence of lower contraceptive uptake among women living in high
HIV-prevalence communities in Kenya.
• Results reveal striking differences in factors associated with contraceptive use
between HIV-positive and HIV-negative women.
• Poverty may be an impediment to contraceptive uptake among HIV-positive women in
Kenya.
Keywords
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Article info
Publication history
Published online: November 08, 2016
Accepted:
October 31,
2016
Received in revised form:
October 28,
2016
Received:
February 16,
2016
Identification
Copyright
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