title: Dual method use for protection of pregnancy and disease prevention among HIV-infected women in South East Nigeria.
abstract: BACKGROUND
  sub-Saharan Africa continue to bear the greatest burden of HIV/AIDS epidemic due to its large population, high fertility rate and unmet contraceptive need, most especially with poor uptake of dual methods (use of condom and another effective family planning method) which protects against STIs/HIV and unplanned pregnancy. The aim of this study was to assess the awareness, pattern and practice of dual methods by HIV infected women, and factors influencing its use in southeast Nigeria.
  
  
  METHODS
  This was a cross sectional descriptive study of 658 HIV positive women attending the PMTCT/postnatal/family planning clinics in three health facilities in southeast Nigeria. An interviewer administered semi-structured questionnaire was used to abstract needed information. The data were analyzed with Epi-info™ version 7.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA), Odd ratio was determined and the test of statistical significance was with Fisher exact test at 95% CI.
  
  
  RESULTS
  The mean age of the participants was 29 ± 4.3 years. All the respondents were aware of their HIV status, 62.4% did not know their partners status; 23.1% were sero-concordant, while 14.5% were sero-discordant. Most (67.9%) of the respondents lack awareness on dual methods with only 179/658 (27.2%) practicing it. The commonest (141/179; 78.9%) dual method used was a combination of condom and injectable hormonal contraceptives. Lack of awareness (222/479; 46.3%) and non disclosure (133/479; 27.8%) were the main reasons for non use of dual method in the present study. STI's was higher amongst non users with odd ratio of 1.74 (1.26-2.41), p-value < 0.0004. Unplanned pregnancy was higher in non users with odd ratio of 3.89 (2.52-6.00), p-value < 0.0000 at 95% CI.
  
  
  CONCLUSIONS
  The awareness and uptake of dual methods amongst HIV infected women in southeast Nigeria is still low and thus associated with a higher risk of STIs and unplanned pregnancy. It is expected that increased awareness, uptake and consistent use will help prevention new infections of HIV/STIs and unplanned pregnancy.
authors.affiliation: School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria. lawkins2000@yahoo.com.
authors.forename: Lucky O
authors.initials: LO
authors.lastname: Lawani
authors.forename: Azubuike K
authors.initials: AK
authors.lastname: Onyebuchi
authors.forename: Chukwuemeka A
authors.initials: CA
authors.lastname: Iyoke
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009549:Nigeria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D049168:Pregnancy, Unplanned; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female