Reproductive Health Needs of Women Living with HIV/AIDS in Yaounde.

Ekane Joan Nange (nangejoan2006@yahoo.com)
General Medicine, Faculty of Medicine and Biomedical Sciences,University of Yaounde I.
July, 2013
 

Abstract

BACKGROUND
HIV (Human Immunodeficiency Virus) infection is one of the most frequent viral infections in our milieu and the rest of the world. It is a major public health problem affecting the whole world. Cameroon with an HIV prevalence of 4.3% is considered one of the countries bearing the greatest burden in Central Africa. The incidence and prevalence of women affected by HIV/AIDS are disproportionately higher than in men, representing more than half of the 33.3 million adults living with HIV/AIDS worldwide. Preventing unintended pregnancies in HIV-positive women can significantly reduce mother-to-child HIV transmission as well as improve the women`s overall health. Contraceptives are safe and effective means to avoid unintended pregnancies. . Our study had as main objective to evaluate the reproductive health needs among women living with HIV/AIDS.
STUDY DESIGN AND METHODS
To attain our objectives we carried out a cross sectional study involving consenting HIV positive women in Yaoundé from October 2012 to March 2013. Recruitment was conducted from both the day care HIV services at the Yaoundé Central Hospital and the Yaoundé Gynaeco-Obstetric and Paediatric Hospital. Women who did not speak French or English and women above reproductive age were excluded from this study. The study objectives, procedures and constraints were explained to each subject. Their consents were sought, and then detailed interactive interview using a preconceived questionnaire was carried out. Data were exported from CSPro version 4.1 to the Statistical Package for Social Sciences (SPSS) version 19.0 software, for analysis. The study was approved by the ethics committee of the Faculty of Medicine and Biomedical Sciences.
RESULTS
A total of four hundred and fifteen women (415) were recruited during the study period. The mean age was 29±7.8 years and the most represented age group was 24- 29 years. The study population was largely single (36.2%) and the women were educated (5 out of 10 had attained university level of education).Regarding the need for cervical cancer screening, 82.4% of the women surveyed believed that screening for cancer of the cervix was necessary with regards to their status but only 30% of them had been screened for cervical cancer at least once. About
screening for sexually transmitted infections, 40% of the women had never been screened for other STIs and only 2% of them had been screened for STIs every six months. We noted that the desire to use modern methods of contraception was high among the women and 63% agreed that they had used at least one method of modern contraceptives but their desire for modern contraceptives was unmet. Among those who used modern contraceptives only 39.1% used condoms.57.1% of the women who were pregnant did not plan to have the pregnancies and out of these, 82% would have wanted a method of contraception (82% unmet needs). The use of modern contraceptive methods was influenced by age (p <0.05) and level of education. Contraceptive use was also high among women who were single (79%) as against 43% among married women (P = 0.00). The desire to have children decreased with age (p = 0.000) and was lower among married women compared to those who were single (54.55% versus 65.4% p =0.000).
CONCLUSIONS
 The use of modern contraception was significantly influenced by age, marital status and level of education. The majority of the women who had unintended pregnancies would have wanted a method of contraception.
 Factors that influenced fertility intentions among HIV positive women were age of the respondents, marital status and the HIV status of their respective partners.
RECOMMENDATIONS
We do recommend to the
 Ministry of Public Health: to integrate reproductive health services such as family planning, screening for cervical cancer and STIs in HIV care services.
 To Health Policy Makers: to develop policies that support availability and accessibility to relevant reproductive and sexual health services, including contraception and procreation, coupled with the need for a public enlightenment program on HIV.
 To Researchers: similar studies should be carried out in different regions all over the country in order to know the real situation in Cameroon.
Keywords: Contraception. Fertility Desire. HIV. Reproductive health. Unintended pregnancy.


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