title: Maternal health care utilization among HIV-positive female adolescents in Kenya.
abstract: BACKGROUND
  Given the health risks of HIV/AIDS and the risks of teenage pregnancy in general, pregnant HIV-positive adolescents in Kenya need maternal health care services that account for their HIV status. However, research on their access to and use of these services is scant.
  
  
  METHODS
  To examine maternal health care utilization, pregnancy history data collected in 2009 on 506 pregnancies among 393 HIV-positive female adolescents aged 15-19 enrolled in HIV/AIDS programs in Kenya were analyzed. Multilevel logit models were used to identify the variables associated with use of prenatal care, prevention of mother-to-child transmission (PMTCT) of HIV, skilled attendance at pregnancy outcomes and postnatal/postabortion care.
  
  
  RESULTS
  Use of PMTCT services was less common than use of prenatal care services among HIV-positive female adolescents (67% of pregnancies vs. 84%). These adolescents made four or more prenatal care visits in only 45% of pregnancies. In addition, use of skilled care during or after abortion or miscarriage was low (20%). The odds of receiving PMTCT services and skilled assistance were higher in Nairobi than in other regions (odds ratios, 3.8 and 2.7, respectively). HIV-positive adolescents were less likely to use maternal health care services for higher-order pregnancies than for lower-order pregnancies (0.4-0.6). They were, however, more likely to receive prenatal care and PMTCT services when their husband rather than someone else was responsible for the pregnancy (3.7 and 4.9, respectively).
  
  
  CONCLUSIONS
  Pregnant, HIV-positive adolescents need maternal health care services--including PMTCT care--that take into account parity, paternity dynamics and regional variations in use.
authors: Population Council, Nairobi, Kenya. fonyango@popcouncil.org
authors: Harriet
authors: H
authors: Birungi
authors: Francis
authors: F
authors: Obare
authors: Anke
authors: A
authors: van der Kwaak
authors: Jane Harriet
authors: JH
authors: Namwebya
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D018743:Perinatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012747:Sexual Partners; D055815:Young Adult