A survey on knowledge, attitudes and practices of HIV-positive women of reproductive age (15-49 yrs) at Katutura health centre towards different family planning methods.

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In recent years there has been an increase in the incidence of pregnancies in HIV-positive women, which increases the risk of mother-to-child transmission (MTCT) of HIV. However, once HIV-positive women become aware of their sera-status, many demonstrate a reduced desire for pregnancy, particularly because most of them know that there are risks involved in delivering an HIV-positive child. Others, on the other hand, want to have children despite their HIV-positive status. Accordingly, HIV-positive women have reproductive needs that have to be respected and attended to. Family planning servtces are the cornerstone of the prevention of MTCT of HIV. Nevertheless, family planning services are not integrated into HIV care and treatment, making it difficult for both HIV-positive women to access such services and for the health care providers to know whether their clients have received these services or not. As a result, many women fall pregnant unintentionally, with some of them accepting the situation, while others opt for back-door abortion services or, if they do not get them, baby dumping becomes an option. The type of the family planning method used by HIV-positive women is influenced on the one hand by the availability and accessibility of different family planning methods and, on the other, by the attitudes of these women and their knowledge of the importance of family planning in HIV-positive women. It is against this background that the researcher carried out a research study that assessed the knowledge, attitudes and practices (KAP) of HIV-positive women of reproductive age ( 15-49 yrs. ), relating to different family planning methods at the Katutura Health Centre. During this KAP study, the researcher used a quantitative, descriptive cross-sectional research method. A standard questionnaire with closed and open-ended questions was employed. The questionnaire comprised four sections, containing demographic, attitude, and knowledge and practice questions respectively. The questionnaire was piloted before data collection to ensure its validity and appropriate changes were made before data collection started. A random sampling method was used to select 34 7 women of reproductive age, that is, between 15 to 49 years, out of a study population. After data collection, all the responses were filled in questionnaires that were identified by number and not by name, hence ensuring anonymity and confidentiality. Verbal consent was sought from those respondents who could not read while written consent note was obtained from literate respondents. Those respondents who started the study but fell out later were allowed to do so with no adverse consequences, and privacy was taken into consideration during the research process. Data analysis was done using a computer program called Epi Info, and appropriate statistics, namely, p-values and chi-squares, were calculated. Throughout the data coding and analysis, the researcher was guided by supervisors who are experienced in the field of research. The study revealed that HIV-positive women of reproductive age ( 15--49 yrs) attending the Katutura Health Centre have good knowledge (95.7%) ofthe importance of family planning in the prevention of MTCT of HIV and a positive attitude (80. 1 %) towards family planning methods and issues generally. Regarding the practices of HIV-positive women towards family planning, the study revealed that 73.7% of women use family planning methods, of whom 57.8% use condoms and only 14.6% use dual family planning methods (condoms and hormonal methods). It is recommended that providers should initiate counselling and family planning services should be provided every time an HIV-positive woman visits care and treatment centres for regular monitoring or check-ups. Health providers responsible for the treatment and care of HIV-positive women should be trained on the importance of family planning and on the appropriate counselling of these women in order to empower them to make informed choices. In order to increase the availability and accessibility of family planning services for HIVpositive women, the responsible authorities should integrate family planning services into the already existing HIV care and treatment services provided countrywide.
A thesis submitted in partial fulfilment of the requirements for the Degree of Master of Public Health.
Reproductive age, Family planning