Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.
Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.
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DOI：
10.1371/journal.pone.0105320
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Padian NS
中科院分区：
文献类型：
--
作者：
McCoy SI;Buzdugan R;Ralph LJ;Mushavi A;Mahomva A;Hakobyan A;Watadzaushe C;Dirawo J;Cowan FM;Padian NS
预防艾滋病毒感染妇女意外怀孕是世界卫生组织推荐的一项预防艾滋病毒母婴传播（PMTCT）的战略。我们评估了津巴布韦最近怀孕的艾滋病毒阳性和艾滋病毒阴性妇女的怀孕意愿和避孕药具使用情况。我们分析了津巴布韦加速国家预防母婴传播计划评估的基线数据。符合条件的妇女是从五个省份提供预防母婴传播服务的 157 个卫生机构的服务区域中随机抽取的。符合条件的女性年龄≥16 岁，并且是访谈前 9 至 18 个月出生的婴儿（活着的或已故的）的母亲。参与者接受了有关艾滋病毒感染状况、生育意图和避孕措施使用情况的采访。在8,797名女性中，平均年龄为26.7岁，92.8%已婚或有固定性伴侣，平均生育2.7次。总体而言，3,090 人 (35.1%) 表示自己的出生是意外的；在这些女性中，分别有 1,477 名 (47.8%) 和 1,613 名 (52.2%) 在得知自己怀孕之前没有使用避孕方法。 12% 的女性表示，在调查时她们的艾滋病毒呈阳性；与自称未感染 HIV 的女性相比，自称感染 HIV 的女性更有可能报告自己意外怀孕（44.9% vs. 33.8%，p<0.01）。调整协变量后，在意外分娩的妇女中，自我报告的艾滋病毒状况与怀孕前缺乏避孕措施之间没有关联。计划生育需求未得到满足和避孕失败导致津巴布韦妇女意外怀孕。感染艾滋病毒和未感染艾滋病毒的妇女尽管打算避免或推迟怀孕，但都报告了意外怀孕，这突出表明需要符合怀孕意图的有效避孕方法。
Prevention of unintended pregnancies among women living with HIV infection is a strategy recommended by the World Health Organization for prevention of mother-to-child transmission of HIV (PMTCT). We assessed pregnancy intentions and contraceptive use among HIV-positive and HIV-negative women with a recent pregnancy in Zimbabwe. We analyzed baseline data from the evaluation of Zimbabwe’s Accelerated National PMTCT Program. Eligible women were randomly sampled from the catchment areas of 157 health facilities offering PMTCT services in five provinces. Eligible women were ≥16 years old and mothers of infants (alive or deceased) born 9 to 18 months prior to the interview. Participants were interviewed about their HIV status, intendedness of the birth, and contraceptive use. Of 8,797 women, the mean age was 26.7 years, 92.8% were married or had a regular sexual partner, and they had an average of 2.7 lifetime births. Overall, 3,090 (35.1%) reported that their births were unintended; of these women, 1,477 (47.8%) and 1,613 (52.2%) were and were not using a contraceptive method prior to learning that they were pregnant, respectively. Twelve percent of women reported that they were HIV-positive at the time of the survey; women who reported that they were HIV-infected were significantly more likely to report that their pregnancy was unintended compared to women who reported that they were HIV-uninfected (44.9% vs. 33.8%, p<0.01). After adjustment for covariates, among women with unintended births, there was no association between self-reported HIV status and lack of contraception use prior to pregnancy. Unmet need for family planning and contraceptive failure contribute to unintended pregnancies among women in Zimbabwe. Both HIV-infected and HIV-uninfected women reported unintended pregnancies despite intending to avoid or delay pregnancy, highlighting the need for effective contraceptive methods that align with pregnancy intentions.
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