Fertility desires, unmet need for family planning, and unwanted pregnancies among HIV-infected women in care in Kinshasa, DR Congo

Pan Afr Med J. 2015 Mar 12;20:235. doi: 10.11604/pamj.2015.20.235.5859. eCollection 2015.

Abstract

Introduction: We assessed the fertility desires, utilization of family planning (FP) methods, and incidence of pregnancies among HIV-infected women receiving care in an HIV clinic with an onsite FP services in Kinshasa, Democratic Republic of Congo.

Methods: Between November 2011 and May 2012, all HIV-infected women who attended a routine visit at the clinic were interviewed about their fertility desires and utilization of contraceptive methods using a structured questionnaire. Routine follow-up visit data were used to identify pregnancies recorded between the interview and June 2013.

Results: Overall, of the 699 HIV-infected women interviewed. 249 (35.7%) reported not wanting another child. Of the 499 (72.2%) participants who were sexually active at the time of interview, 177 (35.5%) were using an effective contraceptive method, including 70 (14.0%) women who reported using condoms consistently and 104 (20.8%) who were using injectable contraception. Overall, 88 (17.6%) sexually active participants who did not want another child were not using an effective FP method, and thus are considered to have had unmet need. During the median follow-up time of 22.2 (IQR: 20.2, 23.6) months, among all women interviewed, 96 (14.1%) became newly pregnant [pregnancy rate 9.3 (95%CI: 7.6, 11.4) per 100 women-years] including 21 (8.7%) among women who initially reported not wanting another child [unwanted pregnancy rate 5.8 (95%CI: 3.6, 9.3) per 100 women-years].

Conclusion: The persistence of relatively high unmet need among women receiving HIV care in a clinic with onsite FP services suggests the existence of barriers that must be identified and addressed.

Keywords: DR Congo; HIV; contraceptives; family planning; unwanted pregnancy.

MeSH terms

  • Adult
  • Aftercare
  • Condoms / statistics & numerical data
  • Contraception Behavior / statistics & numerical data*
  • Democratic Republic of the Congo
  • Family Planning Services*
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • Humans
  • Pregnancy
  • Pregnancy Rate*
  • Pregnancy, Unwanted
  • Surveys and Questionnaires