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Research Article
Rose Naigino
Makerere University
Corresponding Author
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Background
The postnatal period is critical to the delivery of interventions aimed at improving maternal health outcomes. This study established the timing of sexual intercourse resumption after childbirth and associated factors among women living with HIV in Uganda.
Methods
Data were drawn from a larger prospective cohort of 507 HIV+ women who were recruited during pregnancy and followed-up for 18 months between August 2013 and May 2015. Analyses for this study were restricted to 385 women who had complete data on pregnancy outcomes. These women were followed-up for six months after childbirth and interviewed at 5 different time intervals (denoted as days since delivery) starting with 1-45 (acute), 46-90 (sub-acute) and 91-120, 121-150, 151-183 (delayed postpartum). At the initial visit, data were collected on women’s socio-demographic characteristics and the outcome of their latest pregnancy. At subsequent visits, women were asked about currently having a sexual partner, desire for another child, contraceptive use and resumption of sexual intercourse. The primary outcome was the time to resumption of sexual intercourse within six months after childbirth. Survival analysis was used to estimate the time to sexual intercourse resumption based upon the visit at which sexual intercourse was first reported. Factors associated with time to sexual intercourse resumption were established using Cox proportional hazards regression analyses. We obtained adjusted hazard ratios with their 95% confidence intervals. All data analyses were performed using STATA version 14.0.
Results
The cumulative probability of sexual intercourse resumption increased up to 88.2% by the sixth month postpartum. The instantenous probability of sexual intercourse resumption was highest in the delayed postpartum period [68.6% (50.6, 89.3)]. The risk of sexual intercourse resumption was lower when a woman reported having a live-term baby [adj.HR=0.52 (0.31, 0.85)] and an advanced education [adj.HR=0.63 (0.40, 0.98)]. However, currently having a sexual partner [adj.HR=5.97 (3.10, 11.47)]; desire for another child [adj.HR=1.36 (1.08, 1.73)] and contraceptive use [adj.HR=2.21 (1.65, 2.95)] were associated with an increased risk of sexual intercourse resumption.
Conclusion
The majority of women reported resuming sexual intercourse by the sixth month postpartum. Interventions aimed at improving contraceptive uptake should target the delayed postpartum period.
Keywords
HIV, Postnatal, Sexual intercourse, Resumption
Figure 1
Figure 2
No competing interests reported.
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This is a preprint. It has not completed peer review.
Research Article
Rose Naigino
Makerere University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 19 Feb, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The postnatal period is critical to the delivery of interventions aimed at improving maternal health outcomes. This study established the timing of sexual intercourse resumption after childbirth and associated factors among women living with HIV in Uganda.
Methods
Data were drawn from a larger prospective cohort of 507 HIV+ women who were recruited during pregnancy and followed-up for 18 months between August 2013 and May 2015. Analyses for this study were restricted to 385 women who had complete data on pregnancy outcomes. These women were followed-up for six months after childbirth and interviewed at 5 different time intervals (denoted as days since delivery) starting with 1-45 (acute), 46-90 (sub-acute) and 91-120, 121-150, 151-183 (delayed postpartum). At the initial visit, data were collected on women’s socio-demographic characteristics and the outcome of their latest pregnancy. At subsequent visits, women were asked about currently having a sexual partner, desire for another child, contraceptive use and resumption of sexual intercourse. The primary outcome was the time to resumption of sexual intercourse within six months after childbirth. Survival analysis was used to estimate the time to sexual intercourse resumption based upon the visit at which sexual intercourse was first reported. Factors associated with time to sexual intercourse resumption were established using Cox proportional hazards regression analyses. We obtained adjusted hazard ratios with their 95% confidence intervals. All data analyses were performed using STATA version 14.0.
Results
The cumulative probability of sexual intercourse resumption increased up to 88.2% by the sixth month postpartum. The instantenous probability of sexual intercourse resumption was highest in the delayed postpartum period [68.6% (50.6, 89.3)]. The risk of sexual intercourse resumption was lower when a woman reported having a live-term baby [adj.HR=0.52 (0.31, 0.85)] and an advanced education [adj.HR=0.63 (0.40, 0.98)]. However, currently having a sexual partner [adj.HR=5.97 (3.10, 11.47)]; desire for another child [adj.HR=1.36 (1.08, 1.73)] and contraceptive use [adj.HR=2.21 (1.65, 2.95)] were associated with an increased risk of sexual intercourse resumption.
Conclusion
The majority of women reported resuming sexual intercourse by the sixth month postpartum. Interventions aimed at improving contraceptive uptake should target the delayed postpartum period.
Figure 1
Figure 2
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