title: Contraceptive utilization and associated factors among HIV positive women on chronic follow up care in Tigray Region, Northern Ethiopia: a cross sectional study.
abstract: BACKGROUND
  In sub-Sahara Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Maternal to child transmission is responsible for 90% of childhood HIV infection. Preventing unwanted pregnancy among HIV positive women is imperative to reduce maternal and infant morbidity and mortality.
  
  
  METHODS
  A cross-sectional survey was conducted among 964 HIV positive women in selected 12 health centers of Tigray region. In this paper, analysis was restricted only for 847 women who were sexually active and non-pregnant. In each health center the number of study participants was allocated proportionally to the load of HIV positive women in chronic care clinics. The data were entered into EpiData version 3.1, and cleaned and analyzed using Stata version 11.1. Descriptive summary of data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05.
  
  
  RESULTS
  Three hundred ninety four (46.5%) of all HIV positive women had intension to have more children. Three hundred seventy five (44.3%) were using contraceptive methods at time of survey. Injectable (70.7%) and male condom (47.6%) were most commonly used type of contraceptives. In the multivariable analysis, women who were urban dwellers (AOR = 2.55; 95% CI: 1.27, 5.02), completed primary education (AOR = 2.27; 95% CI: 1.12, 2.86) and those openly discussed about contraceptive methods with their husbands or sexual partners (AOR = 6.3; 95% CI: 3.42, 11.76) were more likely to use contraceptive. Women who have one or more living children were also more likely to use contraceptive compared with women with no child.
  
  
  CONCLUSIONS
  Less than half of women used contraceptive methods. The use of condoms could impact unintended pregnancies and reduced risks of vertical and sexual transmission. Efforts to increase contraceptive utilization focusing on the barrier methods should be strengthen in HIV/AIDS chronic care units.
authors.affiliation: Mekelle University, College of Health Sciences, Department of Public Health, Mekelle, Ethiopia.
authors.forename: Yohannes Adama
authors.initials: YA
authors.lastname: Melaku
authors.affiliation: University of Gondar, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia.
authors.forename: Ejigu Gebeye
authors.initials: EG
authors.lastname: Zeleke
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005002:Ethiopia; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D057766:Policy; D011247:Pregnancy; D055815:Young Adult
references.citation: ISRN AIDS. 2013 Sep 25;2013:319724
references.pmid: 24224116
references.citation: AIDS. 2009 Nov;23 Suppl 1:S1-6
references.pmid: 20081381
references.citation: BMC Public Health. 2010 May 13;10:247
references.pmid: 20465794
references.citation: Confl Health. 2011 Sep 20;5:18
references.pmid: 21933403
references.citation: PLoS One. 2012;7(12):e51861
references.pmid: 23284791
references.citation: Reprod Health. 2011 Oct 06;8:27
references.pmid: 21975089
references.citation: PLoS One. 2010 Nov 05;5(11):e13868
references.pmid: 21079770
references.citation: BMC Public Health. 2007 Oct 05;7:282
references.pmid: 17919335
references.citation: BMC Public Health. 2012 Mar 16;12:197
references.pmid: 22424141
references.citation: BMC Infect Dis. 2011 May 23;11:144
references.pmid: 21605418
references.citation: BMC Pregnancy Childbirth. 2013 Jul 15;13:150
references.pmid: 23855776
references.citation: AIDS Care. 2008 Jan;20(1):21-5
references.pmid: 18278611
references.citation: AIDS. 1999 Jun 18;13(9):1083-9
references.pmid: 10397539
references.citation: Fam Plann Perspect. 2001 Jul-Aug;33(4):144-52, 165
references.pmid: 11496931
references.citation: J Int AIDS Soc. 2011 Jun 30;14:35
references.pmid: 21718524
references.citation: Perspect Sex Reprod Health. 2004 May-Jun;36(3):106-13
references.pmid: 15306272
references.citation: Contraception. 2009 Nov;80(5):412-6
references.pmid: 19835713
references.citation: BMC Public Health. 2013 Feb 02;13:98
references.pmid: 23374175
references.citation: Reprod Health Matters. 2003 Nov;11(22):91-100
references.pmid: 14708400
references.citation: PLoS One. 2009 Dec 07;4(12):e7925
references.pmid: 19997556
references.citation: AIDS Behav. 2006 Jul;10(4 Suppl):S95-104
references.pmid: 16715343
references.citation: BMC Womens Health. 2012 Oct 06;12:34
references.pmid: 23039966
references.citation: PLoS One. 2009 Nov 02;4(11):e7691
references.pmid: 19888347
references.citation: BMC Public Health. 2011 Jul 05;11:530
references.pmid: 21726467
references.citation: BMC Public Health. 2013 Jan 30;13:86
references.pmid: 23360397