埃塞俄比亚阿姆哈拉州将计划生育纳入艾滋病毒护理的现状。
Status of family planning integration to HIV care in Amhara regional state, Ethiopia.
机构信息
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ethiopian Federal Ministry of Health, P.O. Box: 1234, Addis Ababa, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2020 Mar 6;20(1):145. doi: 10.1186/s12884-020-2838-x.
BACKGROUND
Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use.
METHODS
A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use.
RESULTS
A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24-0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10-0.37) and women in the age group of 25-34 years (AOR 0.42, 95% CI = 0.20-0.88) and 35-49 years (AOR 0.41, 95% CI = 0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes.
CONCLUSION
This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.
背景
预防 HIV 阳性妇女的意外怀孕是 HIV 预防策略的一个组成部分。然而，预防母婴传播（PMTCT）的项目是从产前保健开始的。本研究的目的是从客户和设施的角度检查计划生育纳入 HIV 护理的现状，并确定与当前计划生育使用相关的因素。
方法
2017 年 12 月至 2018 年 4 月进行了一项基于设施的横断面研究。数据经过编码并双录入 EPI Info 版本 3.5.4，并导出到 STATA 版本 14 进行分析。进行了双变量和多变量逻辑回归分析，以评估变量与当前计划生育使用的关联。
结果
共有 518 名 HIV 阳性妇女纳入研究。在 HIV 阳性妇女中，35.3%有计划生育未满足的需求，21.4%表示怀孕是不想要的。大约三分之二（68.1%）的妇女在研究时正在使用现代计划生育方法。在目前使用计划生育的妇女中，88.8%在同一设施的计划生育诊所获得服务，只有 1.1%在 HIV 护理单位获得服务。不了解 PMTCT 的妇女（AOR 0.47，95%CI=0.24-0.90）、离婚或分居的妇女（AOR 0.19，95%CI=0.10-0.37）和 25-34 岁（AOR 0.42，95%CI=0.20-0.88）和 35-49 岁（AOR 0.41，95%CI=0.17-0.99）的妇女比了解、已婚和 15-24 岁的妇女使用现代计划生育方法的可能性较小。此外，与收入较低的妇女相比，收入较高（AOR 2.12，95%CI=1.26-3.57）的妇女更有可能使用现代计划生育方法。
结论
本研究表明，HIV 阳性妇女的计划生育需求未得到满足，PMTCT/ART 诊所的计划生育服务整合程度较低。应加强努力解决阻碍现代计划生育使用的因素，并改善计划生育服务整合。
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