title: Multi-level Correlates of Safer Conception Methods Awareness and Attitudes Among Ugandan HIV Clients with Fertility Intentions.
abstract: Many people living with HIV desire childbearing, but low cost safer conception methods (SCM) such as timed unprotected intercourse (TUI) and manual self-insemination (MSI) are rarely used. We examined awareness and attitudes towards SCM, and the correlates of these constructs among 400 HIV clients with fertility intentions in Uganda. Measures included awareness, self-efficacy, and motivation regarding SCM, as well as demographics, health management, partner and provider characteristics. Just over half knew that MSI (53%) and TUI (51%) reduced transmission risk during conception, and 15% knew of sperm washing and pre-exposure prophylaxis. In separate regression models for SCM awareness, motivation, and self-efficacy, nearly all independent correlates were related to the partner, including perceived willingness to use SCM, knowledge of respondent's HIV status, HIV-seropositivity, marriage and equality in decision making within the relationship. These findings suggest the importance of partners in promoting SCM use and partner inclusion in safer conception counselling.
authors.affiliation: RAND Corporation, Santa Monica, USA.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
authors.affiliation: RAND Corporation, Santa Monica, USA.
authors.forename: Mahlet A
authors.initials: MA
authors.lastname: Woldetsadik
authors.affiliation: Mulago Hospital, Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Jolly
authors.initials: J
authors.lastname: Beyeza-Kashesya
authors.affiliation: Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City; Schools of Medicine and Pharmacy, University of Missouri - Kansas City.
authors.forename: Kathy
authors.initials: K
authors.lastname: Goggin
authors.affiliation: University of California, Los Angeles Center for Culture and Health, Los Angeles, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Mindry
authors.affiliation: University of Kansas Medical Center, Department of Family Medicine, Kansas City, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Finocchario-Kessler
authors.affiliation: The AIDS Support Organization, Kampala, Uganda.
authors.forename: Sarah
authors.initials: S
authors.lastname: Khanakwa
authors.affiliation: Makerere University School of Public Health, Department of Disease Control and Environmental Health, Kampala, Uganda.
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D005298:Fertility; D015658:HIV Infections; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007315:Insemination, Artificial; D033182:Intention; D008297:Male; D009042:Motivation; D020377:Self Efficacy; D012747:Sexual Partners; D014454:Uganda
keywords: manual self-insemination; self-efficacy; timed unprotected intercourse