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Reproductive Health and Wellness

Contraceptive Use and Uptake of HIVTesting among Sub-Saharan African Women

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Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral
treatment for HIV/AIDS, the disease remains a major public health challenge for women
in sub-Saharan Africa (SSA). Given the numerous barriers in access to care for women in
this region, every health issue that brings them into contact with the health system should be
optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom
forms of modern contraception require a clinical appointment for use, contraception appointments
could provide a confidential opportunity for access to HIV counseling, testing, and
referral to care. This study sought to investigate the relationship between contraceptive
methods and HIV testing among women in SSA. Data from the Demographic and Health
Survey from four African countries—Congo, Mozambique, Nigeria, and Uganda—was used
to examine whether modern (e.g., pills, condom) or traditional (e.g., periodic abstinence,
withdrawal) forms of contraception were associated with uptake of HIV testing. Data for the
current analyses were restricted to 35,748 women with complete information on the variables
of interest. Chi-square tests and logistic regression models were used to assess the relationship
between uptake of HIV testing and respondents' baseline characteristics and contraceptive
methods. In the total sample and in Mozambique, women who used modern forms of
contraception were more likely to be tested for HIV compared to those who did not use contraception.
This positive association was not demonstrated in Congo, Nigeria, or Uganda.
That many women who access modern contraception are not tested for HIV in high HIV burden
areas highlights a missed opportunity to deliver an important intervention to promote
maternal and child health. Given the increasing popularity of hormonal contraception methods
in low-income countries, there is an urgent need to integrate HIV counseling, testing,
and treatment into family planning programs. Women on hormonal contraceptives should be
encouraged to continue to use condoms for HIV-prevention.

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Language
English
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Subject(s)
HIV/AIDS Prevention
Contraceptive
Sub-Saharan African Women
Uptake of HIV Testing
non-condom
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Article
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