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Research article
Joseph KB Matovu(New Corresponding Author)
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6480-2940
License:
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Introduction: HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming.
Methods: Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.
Results: Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n=656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33).
Conclusion: Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.
Keywords
Contraceptives, Family planning counselling, HIV positive women, Postnatal, Antenatal care, delivery
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CURRENT STATUS: Published
View the published article at BMC Women's Health.
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Posted 10 Apr, 2020
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On 11 Apr, 2020
Editorial decision: Accept
On 09 Apr, 2020
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Editorial decision: Minor revision
On 03 Apr, 2020
Editor assigned
On 31 Mar, 2020
Submission checks complete
On 30 Mar, 2020
Editor invited
On 30 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 27 Mar, 2020
Reviewer #1 agreed
On 12 Mar, 2020
Review #1 received
Received 12 Mar, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Major revision
On 07 Jan, 2020
Review #1 received
Received 06 Jan, 2020
Review #2 received
Received 03 Jan, 2020
Reviewer #2 agreed
On 09 Dec, 2019
Reviewer #1 agreed
On 08 Dec, 2019
Reviewers invited
Invitations sent on 05 Dec, 2019
Submission checks complete
On 16 Oct, 2019
Editor assigned
On 08 Oct, 2019
Editor invited
On 07 Oct, 2019
First submitted
On 04 Oct, 2019
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Subject Areas
Preventive Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Women's Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Joseph KB Matovu(New Corresponding Author)
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6480-2940
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Women's Health.
Version 4
Posted 10 Apr, 2020
No community comments so far
Submission checks complete
On 11 Apr, 2020
Editorial decision: Accept
On 09 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 03 Apr, 2020
Editor assigned
On 31 Mar, 2020
Submission checks complete
On 30 Mar, 2020
Editor invited
On 30 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 27 Mar, 2020
Reviewer #1 agreed
On 12 Mar, 2020
Review #1 received
Received 12 Mar, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Major revision
On 07 Jan, 2020
Review #1 received
Received 06 Jan, 2020
Review #2 received
Received 03 Jan, 2020
Reviewer #2 agreed
On 09 Dec, 2019
Reviewer #1 agreed
On 08 Dec, 2019
Reviewers invited
Invitations sent on 05 Dec, 2019
Submission checks complete
On 16 Oct, 2019
Editor assigned
On 08 Oct, 2019
Editor invited
On 07 Oct, 2019
First submitted
On 04 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Preventive Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Women's Health.
Introduction: HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming.
Methods: Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.
Results: Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n=656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33).
Conclusion: Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.
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