Unmet need for contraception among human immunodeficiency virus-positive women in Jos, Nigeria: A call to integrate family planning and human immunodeficiency virus services

Abstract

PURPOSE: In the prevention of mother‑to‑child transmission (PMTCT) of human immunodeficiency virus (HIV), contraception is one of the four strategies proposed by the World Health Organization. Closing the gaps of unmet need for contraception among people living with HIV (PLHIVs) is critical, especially for Nigeria which contributes about 30% of global PMTCT burden. We assessed contraceptive utilization and needs, partner support, and planning of pregnancies among female PLHIVs receiving care at the HIV Treatment Centre of Jos University Teaching Hospital (JUTH). MATERIALS AND METHODS: Structured questionnaires were administered to 350 postpartum women attending the PMTCT Unit of HIV Clinic of the JUTH in 2009 using a convenience sampling method. This was to access their knowledge and utilization of contraception. All were receiving PMTCT follow‑up and were within 18 months postpartum. The data were analyzed with the Epi Info Statistical Package version 3.3. RESULTS: The participants’ ages ranged 19–44 years and 81.4% were Christians. Most (36.1%) were homemakers and 87.1% were married. About 44.1% were discovered to be HIV positive during antenatal care, and 47.6% of husbands were HIV positive. The previous pregnancies had been planned in 38%, thus 62% of preceding pregnancies were unplanned, while 33.8% did not desire more children. Contraception awareness was high (84.5%) but 87.1% of the participants used no form of female contraception and 81.4% admitted regular sexual activity. Among those who did not desire more pregnancies, only 48.4% used modern female contraception. Majority (80.7%) of the respondents indicated that family planning (FP) would be easily accessed in the HIV clinic while male partners (49.4%) encouraged contraception. CONCLUSION: Among PLHIVs in northern Nigeria, there is a high rate of unintended pregnancy, and high contraceptive awareness did not translate into usage. Integration of HIV and reproductive health services holds potential to improve FP access and usage by PLHIVs.