Determinants of contraceptives preference and use among people living with hiv and aids in rural areas: a study of Nyamarambe division, Kisii county, Kenya

Abstract

The World Health Organization (WHO) estimates that a majority of persons living with the Human Immunodeficiency Virus HIV) and the Acquired Immunodeficiency Syndrome (AIDS) are within the reproductive age of 25-49 years. This implies that their sexual and reproductive rights which have to be protected as enshrined in international and national legal instruments. One avenue through which persons living with HIV and AIDS (PLWHAs) can enjoy these rights is through the use of contraceptives. In recognition of this, governments, including that of Kenya, have made contraceptives available and accessible in most parts of the country. However, despite the obvious benefits, availability and accessibility, the uptake of contraceptives is still at only 69% in Kenya. This study therefore sought to investigate the determinants of contraceptives preference and use among PLWHAs in Nyamarambe Division, Kisii County Kenya. The specific objectives of the study were to: examine the level of contraceptive knowledge and use; establish the most preferred contraceptive methods and explore the factors that influence the preference and use of contraceptives. The study was guided by the social cognitive and the protection motivation theories. It applied the mixed method approach through which both qualitative and quantitative data were collected and analyzed using the descriptive survey design. The target population for this study group were 1,206 PLWHAs attending government health facilities for anti-retroviral therapy (ART). Out of these, a sample of 107 was selected through cluster, quota and systematic random sampling techniques. Data were collected using a questionnaire, focus group discussions (FGDs) and interviews, strictly observing all ethical considerations. The findings of this study indicate that 93% of the respondents were knowledgeable about contraceptive use as 77% knew the use and its importance. The study also found that the implant was the most commonly used contraceptive, with more than 29% preferring its use, as opposed to 19.3% who chose to use IUCD method and 18.2% who were inclined to condom method. The study further revealed that the prevalence in the use of the implant was largely influenced by healthcare workers whose percentage was at 48.9%, who tend to recommend the method over other methods. The study also established that some of the factors that influence contraceptive preference and use include adequate information pertaining its presence and its availability of a contraceptive in a health center or in a region. Interestingly, the study revealed that despite assurances by government about availability of contraceptives at health facilities, clients were limited in terms of choice, and that only implants, male condoms and IUCD were available at the facilities in the study area. This study recommends that the government through the ministry of education should incorporate family planning education in secondary schools as this would help them have knowledge and understanding of the use of various contraceptives while the ministry of health is also encouraged to provide numerous contraceptive methods and also train health workers on their importance in enhancing contraceptive use among PLWHA.