Contraceptive Service Uptake and Delivery Preferences in Perinatally and Horizontally Infected Female Adolescents Living with HIV: Results from a South Africa-Based Mixed-Methods Study'.

Autor: Olagbuji B; Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa. Electronic address: biodun_olagbuji@yahoo.com., Cooper D; Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; School of Public Health, University of the Western Cape, South Africa., Mathews C; Health Systems Research Unit, South Africa Medical Research Council, South Africa., Moodley J; Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
Jazyk: angličtina
Zdroj: Journal of pediatric and adolescent gynecology [J Pediatr Adolesc Gynecol] 2022 Dec; Vol. 35 (6), pp. 692-701. Date of Electronic Publication: 2022 May 20.
DOI: 10.1016/j.jpag.2022.05.001
Abstrakt: Study Objective: To investigate whether contraceptive service uptake (including current contraceptive use), unmet need for contraception, unintended pregnancy, preferences for service provision, and providers among female adolescents living with HIV (ALHIV) vary with HIV-acquisition route, that is, perinatal HIV acquisition vs horizontal HIV acquisition.
Design: Mixed methods including exit and in-depth interviews SETTING: Multicenter, public sector primary health care facilities, Cape Town, South Africa PARTICIPANTS: Sexually experienced female ALHIV aged 14-19 years (n = 303) including both peri/postnatally infected ALHIV (pALHIV) and horizontally infected ALHIV (hALHIV) and health care providers involved in HIV care and treatment services (n = 19) MAIN OUTCOME MEASURES: Current contraceptive use, unintended pregnancy, and preferences for service provision and providers RESULTS: The association between HIV-acquisition route and current use of any contraceptive method (aOR = 1.23; 95% CI, 0.52-2.92) and unintended pregnancy (aOR = 1.02; 95% CI, 0.39-2.67) was not significant. In contrast, pALHIV had significantly decreased odds of receiving dual-method contraception (aOR = 0.02; 95% CI, 0.00-0.38) and significantly increased odds of preferences for younger providers (aOR = 4.45; 95% CI, 2.84-6.97), female providers (aOR = 5.11; 95% CI, 1.25-20.91), and standalone youth clinics (aOR = 7.01; 95% CI, 2.39-20.55) compared with female hALHIV. Qualitative findings indicate that provider positive attitudes, as opposed to judgmental attitudes, encourage pALHIV acceptance of care from any provider regardless of, for example, the provider's age.
Conclusions: Current contraceptive use and unintended pregnancies were similar between pALHIV and hALHIV, but the 2 distinct groups of ALHIV were heterogeneous in terms of dual-method contraception and preferences for type of clinic model and providers. Promoting positive provider attitudes could improve ALHIV's contraceptive uptake.
Competing Interests: Conflicts of Interest Statement All authors declare that they have no conflicts of interest.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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