Desire for children and unmet need for contraception among women living with HIV in Rwanda. Secondary analysis of the 2014/2015 Rwanda DHS.

Abstract

Background A key strategy to minimize infant HIV infection rates from Mother-to-child transmission is reducing the mother’s unmet need for contraception and understanding their fertility desires to better accompany them. In Rwanda, the integration of PMTCT has largely been implemented, and the integration of FP services in ARV clinics is being implemented but there is a still to understand more the factors and strategize better the interventions. We set out to look into the factors associated with the desire for children in the future and unmet need for contraception to limit or space births among HIV positive women. Methods This was a cross sectional study of HIV positive women in the reproductive age, used data from the 2014/15 Rwanda Demographic Health Survey. Data analysis was done using STATA version 13. Bivariate analysis using chi-square test and multivariate logistic regression were used to identify predictors of Desire for children and those for unmet need for contraception. Association with p-value < 0.05 was considered significant. Results A total of 247 women were included in the study. More than Twenty percent were in the 40-44 age group. The mean age (SD) was 33.57 (8.56) years. 39.51% of respondents desired to have children in the future; and 10.63 % reported to have unmet need for contraception.24.41% of respondents had one living child; 62.2% of respondents were not using any contraception method. Being divorced was statistically significant to not desire children in the future compared to those never in union (AOR= 0.2073, 95% CI[0.045,0.963]); Respondents using injections as a contraceptive method were less likely to desire children compared to those not using any method (AOR= 0.1369, 95% CI[0.035,0.537]). Having no religion was statistically significant to have unmet need compared to being catholic (AOR= 36.97, 95% CI[1.73,790.07]); Respondents living in rural places were less likely to have unmet need compared to those living in urban places (AOR= 0.3262, 95% CI[0.108-0.90]). Conclusion HIV positive women do have desire for children in the future and do have unmet need for contraception and needs to be taken into consideration. We recommend specific strategies to ensure HIV positive women have access to contraceptives.