Unmet Need for Contraception among Clients of FP/HIV Integrated Services in Nigeria: The Role of Partner Opposition.
Abstract
While women are aware of family planning (FP) methods in Nigeria, the unmet need for modern contraception remains high. We assessed the association between male partner opposition to FP and unmet need for modern contraception among women seeking anti-retroviral therapy (ART), HIV counseling and testing (HCT) and prevention-of-mother-to-child-transmission of HIV (PMTCT) services in Cross-River State, Nigeria. This secondary analysis used data from a facility-based FP/HIV integration study. Logistic regression was used to model the association of interest. Unmet need for modern contraception was high among all clients – ART (49%), HCT (75%), and PMTCT (32%). Perceived partner opposition to FP was widespread (≥70%); however, multivariate analysis showed no significant association with unmet need for modern contraception. Significant covariates were woman’s age, marital status, parity, and previous use of modern contraception. Efforts to improve modern contraceptive use among women at risk of HIV infection in Nigeria should contemplate involving their male partners. Afr J Reprod Health 2014; 18[2]: 134-143).
Keywords: Partner opposition, contraceptive use, HIV/FP service integration, Nigeria
Résumé
Malgré la bonne connaissance des méthodes de la planification familiale (PF) au Nigeria, le besoin non satisfait de la contraception moderne reste élevé. Nous avons évalué l'association entre l’opposition du partenaire masculin à la PF et le besoin non satisfait de la contraception moderne chez les femmes qui recherchent un traitement anti- rétroviral ( TAR), le conseil et le dépistage du VIH CDV) et des services de la prévention de la transmission du VIH de la mère à l’enfant (PTME) dans l’état de Cross River, Nigeria. Cette analyse secondaire a utilisé des données provenant d'une étude d'intégration PF / VIH basée sur un établissement. La régression logistique a été utilisée pour modéliser l'association d'intérêt. Le besoin non satisfait de la contraception moderne était élevé parmi tous les clients - TAR (49 %), CDV (75 %) et la PTME (32 %). La perception de l'opposition du partenaire à la PF était généralisée (≥ 70 %) ; cependant, l'analyse multivariée n’a montré aucune association significative avec le besoin non satisfait de la contraception moderne. Les covariables significatives étaient l'âge de la femme, l'état civil, la parité et l'utilisation antérieure de la contraception moderne. Les initiatives destinées à améliorer l'utilisation de la contraception moderne chez les femmes à risque d'infection du VIH au Nigeria devraient envisager à mobiliser leurs partenaires masculins. Afr J Reprod Health 2014; 18[2]: 134-143).
Mots-clés: L’opposition de la part du partenaire, utilisation des contraceptifs, intégration des services du VIH / FP, Nigeria
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World Health Organization (WHO), Global health sector strategy on HIV/AIDS 2011-2015, Geneva, 2012.
Church K and Mayhew SH, Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature, Studies in Family Planning, 2009, 40(3): 171-186.
Suryavanshi N, Erande A, Pisal H, et al., Repeated pregnancy among women with known HIV status in Pune, India, AIDS Care, 2008, 20(9): 1111-1118.
Hladik W, Stover J, Esiru G, et al., The contribution of family planning towards the prevention of vertical HIV transmission in Uganda, PLoS ONE, 2009, 4(11): e7691. doi:10.1371/journal.pone.0007691
Reynolds H, Janowitz B, Homan R, et al., The value of contraception to prevent perinatal HIV transmission, Sexually Transmitted Diseases, 2006, 33(6): 350-356.
Reynolds H, Janowitz B, Wilcher R, et al., Contraception to prevent HIV-positive births: current contribution and potential cost savings in PEPFAR countries, Sexually Transmitted Infections, 2008, 84(Suppl 2): ii49 - ii53.
Halperin D, Stover J, and Reynolds H, Benefits and costs of expanding access to family planning programs to women living with HIV, AIDS, 2009, 23:123 - 130.
Sedgh G, Hussain R, Bankole A, et al., Women with an unmet need for contraception in developing countries and their reasons for not using a method. New York: Guttmacher Institute, 2007.
Bandura A, Social foundations of thought and action: A social cognitive theory, Englewood Cliffs, NJ: Prentice Hall, 1986.
Bandura A, "Social cognitive theory and exercise of control over HIV infection" in Preventing AIDS: Theories and methods of behavioral interventions, Plenum Press, NY, 1994: 25-59.
McAlister AL, Perry CL, and Parcel GS, “How individuals, environments, and health behaviors interact: Social cognitive theory” in Health behavior and health education: theory, research, and practice, Jossey-Bass, CA, 2008.
Wolff B, Blanc AK, and Ssekamatte-Ssebuliba J, The role of couple negotiation in unmet need for contraception and the decision to stop childbearing in Uganda, Studies in Family Planning, 2000,31(2):124-137.
Singh S and Darroch J, Adding It Up: Costs and Benefits of Contraceptive Services—Estimates for 2012, New York: Guttmacher Institute and United Nations Population Fund (UNFPA), 2012.
McCarraher D, Vance G, Gwarzo U, et al., Changes in contraceptive use following integration of family planning into ART services in Cross River State, Nigeria, Studies in Family Planning, 2011,42(4):283290.
World Health Organization (WHO), Sexual and reproductive health and HIV linkages: evidence review and recommendations. Geneva, 2008.
Chabikuli N, Awi D, Chukwujekwu O, et al., The use of routine monitoring and evaluation systems to assess a referral model of family planning and HIV service integration in Nigeria. AIDS, 2009, 23(Suppl 1):S97S103.
Mark K, Meinzen-Derr J, Stephenson R, et al., Contraception among HIV concordant and discordant couples in Zambia: A randomized controlled trial, Journal of Women's Health, 2007, 16(8):1200-1210.
Bradley H, Gillespie D, Kidanu A, et al., Providing family planning in Ethiopian voluntary HIV counseling and testing facilities: client, counselor and facility-level considerations. AIDS, 2009,23(Suppl 1):S105-S114
Makumbi F, Nakigozi G, Lutalo T, et al., Use of HIVrelated services and modern contraception among women of reproductive age, Rakai Uganda, African Journal of Reproductive Health, 2011,14(4): 91-101.
Ngure K, Heffron R, Mugo N, et al., Successful increase in contraceptive uptake among Kenyan HIV-1- serodiscordant couples enrolled in an HIV-1 prevention trial, AIDS, 2009,23(Suppl 1):S89-S95.
Balkus J, Bosire R, John-Stewart G et al., High uptake of postpartum hormonal contraception among HIV-1seropositive women in Kenya. Sexually Transmitted Diseases, 2007,34(1):25-29.
Winestone L, Bukusi E, Cohen C, et al., Acceptability and feasibility of integration of HIV care services into antenatal clinics in rural Kenya: A qualitative provider interview study. Global Public Health, 2011, 7(2):149-163
Samandari G, Speizer I, and O'Connell K, The role of social support and parity on contraceptive use in Cambodia. International Perspectives on Sexual and Reproductive Health, 2010, 36(3):122-131.
Kaggwa E, Diop N, and Storey D, The role of individual and community normative factors: a multilevel analysis of contraceptive use among women in union in Mali. International Family Planning Perspectives, 2008,34(2):79-88
Imbuki K, Todd C, Stibich M, et al., Factors influencing contraceptive choice and discontinuation among HIVpositive women in Kericho, Kenya, African Journal of Reproductive Health, 2011,14(4):103-114.
Beckman L, Harvey M, Thorburn S, et al., Women's acceptance of the diaphragm: the role of relationship factors, Journal of Sex Research, 2006,43(4):297-306.
Okal J, Stadler J, Ombidi W, et al., Secrecy, disclosure and accidental discovery: Perspectives of diaphragm users in Mombasa, Kenya, Culture, Health and Sexuality, 2008,10(1):13-26.
Salter M, Go V, Celentano D et al., The role of men in women's acceptance of an intravaginal gel in a randomized clinical trial in Blantyre, Malawi: a qualitative and quantitative analysis, AIDS Care, 2008,20(7):853-862.
Montgomery E, van der Straten A, Chidanyika A, et al., The importance of male partner involvement for women’s acceptability and adherence to femaleinitiated HIV prevention methods in Zimbabwe, AIDS and Behavior, 2011,15:959-969.
Ntshebe O, Contraceptive decisions and HIV/AIDS concerns among married couples in Malawi. Journal of Biosocial Science, 2011,43(3):329-343.
Isiugo-Abanihe U, Reproductive motivation and familysize preferences among Nigerian men. Studies in Family Planning, 1994,25(3):149-161.
StataCorp. Stata Statistical Software: Release 13 College Station, TX: StataCorp LP, 2013.
National Population Commission [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2008, Calverton MD, 2009.
Stephenson R, Baschieri A, Clements S, et al., Contextual influences on modern contraceptive use in SubSaharan Africa. American Journal of Public Health, 2007,97:1233–1240.
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