Family planning among people living with HIV in post-conflict Northern Uganda: A mixed methods study

Conflict and Health

Jaya Earnest²  Christopher G Orach³  Sandra C Thompson¹  Jianghong Li⁴  Barbara Nattabi¹ 

[1]Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia

[2]Centre for International Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia

[3]Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda

[4]Telethon Institute for Child Health Research, Perth, Western Australia

[5] Australia

关键词: Northern Uganda;    mixed methods;    contraception;    HIV/AIDS;   

Others  :  810689
DOI  :  10.1186/1752-1505-5-18

 received in 2011-06-03, accepted in 2011-09-20,  发布年份 2011

【 摘 要 】

Background

Northern Uganda experienced severe civil conflict for over 20 years and is also a region of high HIV prevalence. This study examined knowledge of, access to, and factors associated with use of family planning services among people living with HIV (PLHIV) in this region.

Methods

Between February and May 2009, a total of 476 HIV clinic attendees from three health facilities in Gulu, Northern Uganda, were interviewed using a structured questionnaire. Semi-structured interviews were conducted with another 26 participants. Factors associated with use of family planning methods were examined using logistic regression methods, while qualitative data was analyzed within a social-ecological framework using thematic analysis.

Results

There was a high level of knowledge about family planning methods among the PLHIV surveyed (96%). However, there were a significantly higher proportion of males (52%) than females (25%) who reported using contraception. Factors significantly associated with the use of contraception were having ever gone to school [adjusted odds ratio (AOR) = 4.32, 95% confidence interval (CI): 1.33-14.07; p = .015], discussion of family planning with a health worker (AOR = 2.08, 95% CI: 1.01-4.27; p = .046), or with one's spouse (AOR = 5.13, 95% CI: 2.35-11.16; p = .000), not attending the Catholic-run clinic (AOR = 3.67, 95% CI: 1.79-7.54; p = .000), and spouses' non-desire for children (AOR = 2.19, 95% CI: 1.10-4.36; p = .025). Qualitative data revealed six major factors influencing contraception use among PLHIV in Gulu including personal and structural barriers to contraceptive use, perceptions of family planning, decision making, covert use of family planning methods and targeting of women for family planning services.

Conclusions

Multilevel, context-specific health interventions including an integration of family planning services into HIV clinics could help overcome some of the individual and structural barriers to accessing family planning services among PLHIV in Gulu. The integration also has the potential to reduce HIV incidence in this post-conflict region.

【 授权许可】

   
2011 Nattabi et al; licensee BioMed Central Ltd.

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