Jhangri Gian S, Heys Jennifer, Alibhai Arif, Rubaale Tom, Kipp Walter
Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
J Fam Plann Reprod Health Care. 2012 Jan;38(1):23-9. doi: 10.1136/jfprhc-2011-0108. Epub 2011 Jul 27.
This study determined the unmet need for family planning among HIV-positive and HIV-negative individuals living in western Uganda. Semi-structured interviews were conducted with individuals who were randomly selected from HIV testing lists. Of those individuals, further analysis was conducted on a subset of 206 participants who did not desire more children and were not using a highly effective method of contraception. Descriptive, bivariate and multivariate methods were performed to assess the relationship between HIV status and unmet need for effective family planning.
The unmet need for effective family planning was much greater in HIV-infected individuals compared to HIV-negative individuals [75.0% vs 33.8%, adjusted odds ratio (OR) 3.97, 95% confidence interval (CI) 1.97-8.03, p<0.001]. Females were more likely to report an unmet need compared to males (69.0% vs 49.5%; adjusted OR 1.94, 95% CI 0.94-4.00, p=0.071). Other predictors of unmet need for effective family planning were older age (adjusted OR 1.08 for each year of age, 95% CI 1.00-1.16, p=0.018) and single/cohabiting vs being married (OR 2.36, 95% CI 1.16-4.80, p=0.036). Being on antiretroviral therapy was not a predictor of having a lower unmet need for effective family planning methods.
There is high unmet need for effective family planning in HIV-positive study participants in a region of western Uganda, which should be of concern. This suggests that HIV-infected individuals do not want to use family planning or encounter barriers to accessing and utilising family planning services. Family planning programmes and HIV care and prevention services have to work together more effectively to create services conducive to clients from both programmes.
本研究确定了乌干达西部艾滋病毒阳性和阴性个体中未满足的计划生育需求。对从艾滋病毒检测名单中随机选取的个体进行了半结构化访谈。在这些个体中，对206名不想要更多孩子且未使用高效避孕方法的参与者子集进行了进一步分析。采用描述性、双变量和多变量方法评估艾滋病毒感染状况与未满足的有效计划生育需求之间的关系。
与艾滋病毒阴性个体相比，艾滋病毒感染个体中未满足的有效计划生育需求要高得多[75.0%对33.8%，调整后的优势比（OR）为3.97，95%置信区间（CI）为1.97 - 8.03，p<0.001]。与男性相比，女性更有可能报告有未满足的需求（69.0%对49.5%；调整后的OR为1.94，95%CI为0.94 - 4.00，p = 0.071）。未满足的有效计划生育需求的其他预测因素包括年龄较大（每增加一岁调整后的OR为1.08，95%CI为1.00 - 1.16，p = 0.018）以及单身/同居与已婚相比（OR为2.36，95%CI为1.16 - 4.80，p = 0.036）。接受抗逆转录病毒治疗并不是有效计划生育方法未满足需求较低的预测因素。
在乌干达西部某地区，艾滋病毒阳性研究参与者对有效计划生育的需求未得到满足的情况很严重，这值得关注。这表明艾滋病毒感染个体要么不想使用计划生育方法，要么在获取和利用计划生育服务方面遇到障碍。计划生育项目与艾滋病毒护理及预防服务必须更有效地合作，以创建有利于这两个项目客户的服务。
