Attitudes toward Family Planning among HIV-Positive Pregnant Women Enrolled in a Prevention of Mother-To-Child Transmission Study in Kisumu, Kenya.docVIP

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Attitudes toward Family Planning among HIV-Positive Pregnant Women Enrolled in a Prevention of Mother-To-Child Transmission Study in Kisumu, Kenya.doc

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Attitudes toward Family Planning among HIV-Positive Pregnant Women Enrolled in a Prevention of Mother-To-Child Transmission Study in Kisumu, Kenya

AttitudestowardFamilyPlanningamongHIV-Positive PregnantWomenEnrolledinaPreventionof Mother-To-ChildTransmissionStudyinKisumu,Kenya VictorAkelo1,2,SonaliGirde2,3,CraigB.Borkowf2,FrankAngira1,KevinAchola1,RichardLando1, LisaA.Mills4,TimothyK.Thomas4,ShirleyLeeLecher2* 1KenyaMedicalResearchInstitute,Kisumu,Kenya,2DivisionofHIV/AIDSPrevention,U.S.CentersforDiseaseControlandPrevention,Atlanta,Georgia,UnitedStatesof America,3ICFInternational,Atlanta,Georgia,UnitedStatesofAmerica,4U.S.CentersforDiseaseControlandPrevention,HIVResearchBranch,Kisumu,Kenya Abstract Background: Preventing unintended pregnancies among HIV-positive women through family planning (FP) reduces pregnancy-relatedmorbidityandmortality,decreasesthenumberofpediatricHIVinfections,andhasalsoproventobea cost-effectivewaytopreventmother-to-childHIVtransmission.AkeyelementofacomprehensiveHIVpreventionagenda, aimedatavoidingunintendedpregnancies,isrecognizingtheattitudestowardsFPamongHIV-positivewomenandtheir spouseorpartner.Inthisstudy,weanalyzeFPattitudesamongHIV-infectedpregnantwomenenrolledinaPMTCTclinical trialinWesternKenya. MethodsandFindings:Baselinedatawerecollectedon522HIV-positivepregnantwomenusingstructuredquestionnaires. AssociationsbetweendemographicvariablesandthefutureintentiontouseFPwereexaminedusingFisher’sexacttests and permutation tests. Most participants (87%) indicated that they intended to use FP. However, only 8% indicated condoms as a preferred FP method, and 59% of current pregnancies were unintended. Factors associated with positive intentionstouseFPwere:maritalstatus(p=0.04),havingtalkedtotheirspouseorpartneraboutFP(p,0.001),perceived spouseorpartnerapprovalofFP(p,0.001),previoususeofaFPmethod(p=0.006),attitudetowardthecurrentpregnancy (p=0.02),disclosureofasexuallytransmittedinfection(STI)diagnosis(p=0.03)andethnicgroup(p=0.03). Conclusion:AsignificantgapexistsbetweenfutureFPintentionsandcurrentFPpractices.Supportandapprovalbythe spouseorpartnerarekeyelementsofFPintentions.Counse