Predictors of Low Uptake of Modern Contraceptive Methods among women living with HIV in Nyarugenge District, Rwanda

Abstract

Background: HIV infected women are at risk of unexpected pregnancy and sexually transmitted infections. In developing countries like Rwanda, provision of modern family planning methods and counseling to women in child bearing age including those on antiretro therapy (ART) is an important strategy to prevent vertical transmission of HIV. The main objectives were to determine the prevalence of contraceptive uptake and associated factors of low uptake of modern contraceptive methods among women living with HIV in Nyarugenge District, Rwanda. Method: A cross-sectional study design was conducted and the qualitative approach with focus group discussion was conducted to support the quantitative method. Data were collected from 633 HIV-positive women in reproductive age using structured questionnaires and then the simple random sampling technique was used to obtain information from the respondents. Data were analyzed using STATA version 13.0. Bivariate and multivariate analysis were used to identify the factors associated with low use of contraceptive methods. The significance level was set at 5%. Results: The prevalence of current contraceptive uptake was 80%.Injectable (47.24%) and Implants (25.43%) were found to be the most used contraceptive methods. Low contraceptive uptake was associated with the lack of health insurance with approximately 2 times higher odds [AOR= 2.49; 95% CI =1.46-4.24; p =0.01] compared to those who had health insurance; the long waiting time at health facilities [AOR= 0.26; 95% CI = 0.14-0.48; p =0.000]. Muslims followers were found about 2 times more likely to be non-users of modern contraceptive methods [AOR= 1.95; 95% CI = 1.15-3.32; p =0.013] than those who were Christians. Conclusion: Low uptake of modern contraceptive use was found associated with lack of health insurance, long waiting time at health facility, and religion belief. The study suggests that, counseling focusing on the adhesion on health insurance and the use of long-acting reversible contraceptive (LARC) , good customer care to increase the uptake of modern contraceptive among HIV positive.Socio demographic characteristics such as age, marital status, level of education were found to bet not associated with modern contraceptive use.