Department of Public Health, Mettu University, Mettu, Ethiopia.
Department of Population and Family Health, Jimma University, Jimma, Ethiopia.
PLoS One. 2021 Apr 16;16(4):e0250297. doi: 10.1371/journal.pone.0250297. eCollection 2021.
BACKGROUND: Unmet need for family planning is a measure of the gap between women's contraceptive behavior and their fertility desires. It should be measured among different population groups to effectively implement public health interventions. Thus, this study aimed to determine the magnitude of unmet need for family planning and associated factors among HIV- positive women in Dire Dawa city Anti-retroviral treatment (ART) clinics, Eastern Ethiopia. METHODS: We carried out a facility-based cross-sectional study (March-June 2020) among 409 married women aged 15-49 on ART, using systematic random sampling. A face-to-face interview was done using a structured questionnaire. Bivariable and multivariable logistic regression was done to identify factors associated with unmet need for family planning. RESULTS: Overall, 33% [95% confidence interval (CI): 28.9-37.9] of the respondents had unmet need for family planning. Woman's residing in a rural area (adjusted odds ratio (AOR): 2.41 [95% CI: 1.24-4.67]), woman's not attained formal education (AOR: 4.14 [95% CI: 1.73-9.93]) and attaining primary education (AOR: 2.97 [95% CI: 1.54-5.74]), poor knowledge (AOR: 2.87 [95% CI: 1.52-5.40]), and unfavorable attitude towards family planning (AOR: 2.21 [95% CI: 1.12-4.34]), clients not satisfied with family planning service (AOR: 6.34 [95% CI: 3.31-12.15]), the woman not having decision making power on family planning (AOR:3.97 [95% CI: 2.14-7.38]) and not getting family planning counseling in ART clinics (AOR: 2.87 [95% CI: 1.54-5.35]) were positively associated with having unmet need for family planning. CONCLUSION: This study indicates there a high unmet need for family planning among married HIV-positive women. Factors like a place of residence, educational status of women, knowledge and attitude towards family planning, client satisfaction with FP service, women decision-making power, and FP counseling service in ART. Therefore, we recommend that the concerned bodies should collaborate with ART clinics to design interventions that enhance access to family planning programs to combat the high unmet need for family planning among HIV-positive women.
背景：计划生育未满足需求是衡量妇女避孕行为与生育意愿之间差距的指标。为了有效实施公共卫生干预措施，应在不同人群中进行测量。因此，本研究旨在确定埃塞俄比亚东部迪雷达瓦市抗逆转录病毒治疗 (ART) 诊所中 HIV 阳性妇女的计划生育未满足需求的程度及其相关因素。
方法：我们在 2020 年 3 月至 6 月期间，使用系统随机抽样，对 409 名年龄在 15-49 岁之间、正在接受 ART 治疗的已婚妇女进行了一项基于机构的横断面研究。使用面对面访谈的方式，使用结构化问卷进行调查。采用单变量和多变量逻辑回归分析确定与计划生育未满足需求相关的因素。
结果：总体而言，33%（95%置信区间：28.9-37.9）的受访者存在计划生育未满足需求。居住在农村地区的妇女（调整后的优势比（AOR）：2.41 [95%置信区间：1.24-4.67]）、未接受正规教育的妇女（AOR：4.14 [95%置信区间：1.73-9.93]）和接受过小学教育的妇女（AOR：2.97 [95%置信区间：1.54-5.74]）、知识水平差（AOR：2.87 [95%置信区间：1.52-5.40]）和对计划生育的不利态度（AOR：2.21 [95%置信区间：1.12-4.34]）、对计划生育服务不满意的客户（AOR：6.34 [95%置信区间：3.31-12.15]）、妇女在计划生育方面没有决策权（AOR：3.97 [95%置信区间：2.14-7.38]）和未在 ART 诊所接受计划生育咨询（AOR：2.87 [95%置信区间：1.54-5.35]）与计划生育未满足需求呈正相关。
结论：本研究表明，已婚 HIV 阳性妇女的计划生育未满足需求较高。一些因素，如居住地、妇女的教育程度、对计划生育的知识和态度、对 FP 服务的满意度、妇女决策权以及 ART 诊所中的 FP 咨询服务，都与计划生育未满足需求有关。因此，我们建议有关机构应与 ART 诊所合作，设计干预措施，以增加计划生育方案的获取机会，以应对 HIV 阳性妇女计划生育未满足需求较高的问题。
Matern Child Health J. 2017-3
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