Dual Contraception Prevalence among Seropositive Women in Discordant Marital Relationships in Nyatike Sub-County, Kenya

Abstract

HIV-discordant couples are faced with dual problem of preventing unwanted pregnancy and HIV transmission to uninfected partner. Dual contraception involving consistent use of condoms to prevent STIs/HIV infection and another more effective modern contraceptive for pregnancy prevention has been recommended to offer dual protection for discordant couples. However a large proportion of new HIV infections and unwanted pregnancies in Sub-saharan Africa still occur in stable HIV-discordant partnerships and Nyatike Sub-county in Migori County, Kenya is no exception. The objectives of this study were to find out the prevalence of dual contraception, and to find out the most common form of dual contraception among seropositive women in discordant marital relationships in Nyatike Subcounty in Migori County, Kenya. A cross-sectional survey design was employed. Fourteen health facilities were purposively sampled within Nyatike Sub-county. A total of 174 randomly sampled seropositive women in discordant marital relationships were subjected to interviewer administered semi-structured questionnaire. Two focused group discussions (FGDs) involving fourteen seropositive women randomly sampled were conducted. Additionally, the study involved 28 in-depth interviews with fourteen randomly sampled seronegative men in discordant relationships and fourteen purposively sampled healthcare providers (key informants). Quantitative data was analyzed using frequencies and percentages while Content analysis was used to analyze qualitative data. Tables were used to present research results. The study revealed low dual contraception prevalence 29.3%. Condom plus injections was the most used form of dual contraception to offer dual protection at 24.1%. Partner refusal, perceived and real side effects, religious beliefs and desire for biological child were the main barriers to dual contraception use. The study recommends formulation of HIV integrated FP programs that intensify efforts in improving knowledge of dual contraception use among seropositive women and its critical health benefits, coupled with encouraging constructive male partner communication and engagement in order to increase dual contraception uptake.