Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA.
Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, USA.
BMJ Open. 2019 Jan 7;9(1):e022221. doi: 10.1136/bmjopen-2018-022221.
Despite the availability and knowledge of various contraceptive methods, consistent utilisation in women living with HIV/AIDS (WLWHA) within the reproductive age group remains below the Sustainable Development Goals (SDGs) and Family Planning 2020 goals. This study examines the association between sociodemographic factors and contraceptive use including the effect of clustering tendencies of these factors on contraceptive usage among WLWHA in Kenya.
Weighted multivariate logistic regression models were conducted to determine the association of sociodemographic factors on contraception use among WLWHA using the 2008-2009 Kenya Demographic Health Survey. Spatial autocorrelation techniques were used to explore clustering tendencies of these factors on contraception utilisation. Our study population included 304 HIV positive women, aged 15-49 years.
Among 304 HIV-positive women in our study population, 92 (30.3%) reported using one method of contraception. Contraceptive use was significantly associated with wealth and education after adjustment for other sociodemographic variables. Women classified as having low and middle wealth index were less likely to use contraceptives (OR=0.17, 95% CI 0.07 to 0.43; OR=0.33, 95% CI 0.11 to 0.98, respectively) compared with women classified as having high wealth index. Similarly, women with primary education only were less likely to use contraceptives compared with women with secondary or higher education (OR=0.42, 95% CI 0.18 to 0.98). Spatial autocorrelation revealed significant positive clusters with weak clustering tendencies of non-contraceptive use among different levels of wealth index and education within different regions of Kenya.
These findings underscores the need for intervention programmes to further target socially disadvantaged WLWHA, which is necessary for achieving the SDGs.
尽管有各种避孕方法可供选择，并且人们对这些方法有一定了解，但在处于生育年龄阶段的艾滋病毒/艾滋病感染者（PLWHA）中，避孕方法的持续使用率仍低于可持续发展目标（SDGs）和计划生育 2020 目标。本研究旨在探讨社会人口因素与避孕方法使用之间的关联，包括这些因素的聚类趋势对肯尼亚 PLWHA 避孕方法使用的影响。
我们采用加权多变量逻辑回归模型，利用 2008-2009 年肯尼亚人口与健康调查的数据，确定社会人口因素与 PLWHA 避孕方法使用之间的关联。我们还使用空间自相关技术来探索这些因素在避孕方法使用方面的聚类趋势。我们的研究人群包括 304 名年龄在 15-49 岁之间的 HIV 阳性女性。
在我们的研究人群中，有 304 名 HIV 阳性女性报告使用了一种避孕方法，使用率为 30.3%。经过对其他社会人口变量进行调整后，财富和教育状况与避孕方法的使用显著相关。与财富指数较高的女性相比，财富指数较低和中等的女性使用避孕方法的可能性较低（OR=0.17，95%CI 0.07 至 0.43；OR=0.33，95%CI 0.11 至 0.98）。同样，与具有中学或更高学历的女性相比，仅接受过小学教育的女性使用避孕方法的可能性较低（OR=0.42，95%CI 0.18 至 0.98）。空间自相关分析显示，在肯尼亚不同地区，不同财富指数和教育水平的非避孕方法使用存在显著的正聚类，且聚类趋势较弱。
这些发现强调了需要针对社会地位较低的 PLWHA 实施干预计划，这对于实现 SDGs 目标至关重要。
