Case records and commentaries in Obstetrics and Gynaecology
The aim of the study was to determine the knowledge, attitude and contraception use among HIV infected women attending Comprehensive Care Center at Kenyatta National Hospital. This was a hospital based cross-sectional descriptive study. A structured questionnaire was administered. Comprehensive Care Centre (CCC), Kenyatta National Hospital Non pregnant HIV positive women on follow up at the CCC. A total of 94 HIV infected women were interviewed between May 2006 and August 2006 through a pre-tested interviewer administered questionnaire. Consecutive women willing to participate in the study were interviewed. The mean age of the respondents was 34 years with their ages ranging from 21 to 49 years. Almost half (47.9%) of the study group were married, all had formal education and about three quarters (74.6%) were employed. HIV test results disclosure to sexual partners was high (87.5%).However, HIV status of the sexual partners was not known in nearly forty percent (39.2 %). Knowledge on specific contraceptive methods which can be used by HIV infected women was varied. Knowledge that condoms provide dual protection was high (87.2%) while that of dual method use was low (45.7%). There was positive attitude (76.6%) towards contraceptive use by HIV infected women. Majority (86%) of the respondents did not have reproduction intentions in the next 2 years. However, only 44.2 % of the respondents were using contraception. 345 Condoms were the most popular (81.5%) contraceptive method .Female condom was used bylO.S% of the respondents. Norplant was the only long term contraceptive method and was used by only2.6%. Dual method of contraception was practiced by13.S%. Majority of the respondents obtained contraceptives from private sector (42.9%) with less than 10% getting them from CCc. Only 4.2% of non users of contraceptives received family planning counseling at the CCC. The unmet need for family planning among the study group was 30%. Education and regular sexual partner were significantly associated with positive attitude towards use of contraception in HIV infection. Marital status and regular sexual partner were significantly associated with contraceptive use. Knowledge of contraceptive methods HIV infected women can use is low. There is positive attitude towards .use of contraceptives by HIV infected women. Majority of respondents do not intend to have a child in the next 2 years hence need for effective contraception. Only 44% are on contraception. Dual method use is low among the study group (13.S%).Also use of long term contraceptive methods is low among respondents. Majority of the respondents obtained contraceptives away from CCC.The unmet need for family planning is high at 30%. Comprehensive Care Center should provide family planning services to HIV infected women on treatment and follow up at the centre or establish linkage with KNH family planning clinic. Dual method use should be encouraged to ensure high protection against pregnancy as well as protection against HIV and other STls among HIV positive couples. The unmet need of family planning is high and requires to be addressed to prevent unwanted pregnancies. Couple/Partner counseling should be enhanced to take care of the high number of unknown HIV status among partners.