To use or not to use a condom: A prospective cohort study comparing contraceptive practices among HIV-infected and HIV-negative youth in Uganda

Beyeza-Kashesya, Jolly; Kaharuza, Frank; Ekström, Anna Mia; Neema, Stella; Kulane, Asli; Mirembe, Florence
January 2011
BMC Infectious Diseases;2011, Vol. 11 Issue 1, p144
Academic Journal
Background: Unwanted pregnancy and HIV infection are issues of significant concern to young people. Limited data exists on contraceptive decision-making and practices among HIV-infected and HIV-negative young people in low resource settings with generalized HIV epidemics. Methods: From July 2007 until April 2009, we recruited, and followed up over a one year period, a cohort of 501 HIV-negative and 276 HIV-infected young women and men aged 15-24 years residing in Kampala and Wakiso districts. We compared contraceptive use among HIV-infected and HIV-negative young people and assessed factors associated with contraceptive decision-making and use, using multivariate logistic regression modelling to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: Contraceptive use among sexually active HIV-infected young people was 34% while it was 59% among the HIV-negative group. The condom was the most frequently used method of contraception. Only 24% of the HIV-infected used condoms consistently compared to 38% among the negative group OR 0.56 (95% CI 0.38, 0.82). HIV-infected young people were more likely to discuss safe sex behaviour with health workers OR 1.70 (95% CI 1.13, 2.57), though its effect on fertility decision-making was not significant. Throughout the year's follow-up, only 24% among the HIV-negative and 18% among the HIV-infected continued to use contraception while 12% and 28% among the HIV-negative and infected respectively did not use contraception at all. At multivariate analysis, the HIV-infected young people were less likely to maintain contraceptive use. Other factors independently associated with sustained contraceptive use were age of the respondent, marital status and being a male. Conversely, HIVinfected young people were less likely to initiate use of contraception. Being married or in a relationship was associated with higher odds of initiating contraceptive use. Conclusion: Compared to the HIV-negative group, sexually active HIV-infected young people are less likely to use contraception and condoms. Initiating or sustaining contraceptive use was also significantly less among the HIVinfected group. Strengthening family planning services and developing new innovative ideas to re-market condom use are needed. Policy and guidelines that empower health workers to help young people (especially the HIV infected) express their sexuality and reproduction should urgently be developed.


Related Articles

  • A right for family planning. Charlafti, Ilias // EMBO Reports;Mar2002, Vol. 3 Issue 3, p211 

    This article focuses on the benefits of contraception for women's health and social status. Contraception was indeed the big bang in the evolution of baby-making strategies. Nowadays, the increasingly wide variety of contraceptive methods are available to both sexes, such as oxymoron that people...

  • 18b: Contraception and unwanted pregnancy (i). Kraszewski, Sarah // Practice Nurse;10/15/2004, Vol. 28 Issue 6, p75 

    Discusses issues concerning contraception and unwanted pregnancy. Definition of sexual health; Ways of improving sexual health; Consequences of poor sexual health; Methods of contraception.

  • LARC methods: when to prescribe. Farmer, Lucinda // Update;Oct2006, Vol. 73 Issue 4, p71 

    The article presents information about the use of long-acting reversible contraception (LARC) methods. Recently, the National Institute of Clinical Excellence (NICE) issued a set of guidelines revealing that the use of LARC apparently lessens the chances of unwanted pregnancies. The NICE also...

  • PREVALENCE OF INDUCED ABORTION IN TAMIL NADU, INDIA: AN ANALYSIS. Krishnamoorthy, S. // Journal of Family Welfare;Dec2006, Vol. 52 Issue 2, p32 

    The article discusses the analysis on the prevalence of induced abortion in Tamil Nadu, India. The study examined whether abortions were more frequent among those pregnancies for which such tests were carried out. It also indicates that use of temporary methods of contraception to space...

  • Desafios da contracepção juvenil: interseções entre género, sexualidade e saúde. Brandão, Elaine Reis // Revista Ciência & Saúde Coletiva;2009, Vol. 14 Issue 4, p1063 

    This paper shows, from a socioanthropological perspective, the challenges young people face in managing their sexual and affective lives, when it comes to preventing unexpected pregnancy. It aims to discuss some of the difficulties young people have when dealing with contraception along their...

  • Homeless Women: Who is Really at Risk for Unintended Pregnancy? Gelberg, Lillian; Lu, Michael C..; Leake, Barbara D.; Andersen, Ronald M.; Morgenstern, Hal; Nyamathi, Adeline M. // Maternal & Child Health Journal;Jan2008, Vol. 12 Issue 1, p52 

    Objective To identify correlates of failure to use contraception among homeless women at risk for unintended pregnancy. Study Design A representative sample of 974 homeless women surveyed in Los Angeles County in 1997 included 457 who were at risk for unintended pregnancy. Logistic regression...

  • Pain and heavy bleeding with intrauterine contraceptive devices. Rose, Sally B. // BMJ: British Medical Journal (International Edition);9/1/2007, Vol. 335 Issue 7617, p410 

    This editorial comments on the two uterine contraceptive devices (IUDs) available to most women who seek birth control without chemicals. Studies show that most women who stop using IUDs do so because of heavy bleeding and pain during menstruation. The author says that this form of birth control...

  • Factors affecting unmet need for family planning in Eastern Sudan. Ali, Abdel Aziem A.; Okud, Amira // BMC Public Health;2013, Vol. 13 Issue 1, p1 

    Background: In the developing countries millions of women in the reproductive age who don't use contraceptives prefer to postpone or limit their birth. This indicates their failure to take necessary decision to prevent and avoid unwanted pregnancy. Methods: A community-based cross sectional...

  • Bedsider aims to make contraception cool.  // Contemporary Sexuality;Nov2011, Vol. 45 Issue 11, p8 

    The article looks at Bedsider, a website and text messaging service from the National Campaign to Prevent Teen and Unplanned Pregnancy which offers information and scheduling services for birth control and sexual health.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics