Abstract

Background: Family Planning (FP) programs have helped women globally to avoid millions of unintended pregnancies which could be associated with abortions, morbidity, and mortality on mothers and newborns. Globally, about 220 million women have the unsatisfactory need for FP and 80 million unexpected pregnancies occur each year and in sub-Saharan Africa around 14 million each year. In 2018, the prevalence of unplanned pregnancies among HIV women was estimated to be 44% globally and 68% in the USA, 35% - 65% in sub-Saharan Africa and 71% in South Africa. Pregnancy in HIV infection has been reported to be associated with increased risks of morbidity, mortality and psychological complications such as: depression, suicidal thoughts and anxiety. In the Mbeya region where the prevalence of HIV is high, little is known on the prevalence and the factors associated with unintended pregnancy among HIV positive women.

Objective: Therefore, the present study aimed to determine the prevalence and factors associated with unintended pregnancies among HIV women in Mbeya region.

Method: This was a health facility-based cross-sectional study that was conducted from January to February 2020 among 388 HIV-infected pregnant women at seven Health facilities in Mbeya Region. London Measure of Unintended Pregnancy tool was used for assessing the features of unintended pregnancy. Data were analyzed using STATA version 15.1, where the p-value < 0.05 was considered to be statistically significant.

Results: The prevalence of unintended pregnancy was 61.14% (n = 388). The mean age of the participants was 28.35 (SD = 7.20) years. Among the age group of 25 - 34 years of women 112 (61.20%) had unplanned pregnancies. After adjusted analysis, women with single marital status, private employee, drinking alcohol, do not use contraceptive method, testing for CD4 and HIV Viral load were found to have statistical significant associated on unintended pregnancy. On the use of any contraceptive method, the odds of unintended pregnancy among the women who don’t use contraceptive method were 2.08 times more likely than those who use contraceptive method (aPR = 2.08; 95%CI; 1.60 - 2.70) at p < 0.001. Also, the odds of having unintended pregnancy among the women who had tested for low CD4 count (0 - 349 cells/mm³) were 1.28 times more likely than those who had tested CD4 count greater than or equal to 350 cells/mm³ (aPR = 1.28; 95%CI; 1.02 - 1.61) at p < 0.03.

Conclusion: The present study revealed that over half (61.14%) of the HIV-infected pregnant women attending RCH/ANC in Mbeya Region had unplanned pregnancy experience. This indicates unintended pregnancy is one of the major reproductive health problems in PMTCT and also in the study area.

Keywords: Unintended Pregnancy; Family Planning; HIV; PMTCT; RCH, ANC; CD4

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