Contraceptive knowledge, attitude and practices amongst adult HIV positive females in the John Talo Gaetsewe Health District
Background Adult females recently diagnosed HIV positive fall pregnant soon after diagnosis in John Taolo Gaetsewe Health District. They usually claim ignorant of or say they forgot to take their pills and that lead to their getting pregnant. Considering the health implication of pregnancy on the general health outlook of HIV positive females and risk of mother to child transmission of HIV, that motivated this study. Aim and Objectives To study the contraceptive knowledge, attitude and practices amongst adult HIV positive females in John Taolo Gaetsewe Health District. The objectives are; 1. To evaluate contraceptive knowledge, perceptions and practices amongst patients presenting for contraception 2. To find out the reasons for use and non use of contraceptives by patients 3. To determine choices of contraceptive methods, use of emmergency contraception and barrier contraception such as condoms. Methods Study design: A cross sectional descriptive study focused on determining the contraceptive knowldge, attitude and practices of adult HIV positive females between the ages of 18 and 49 were selected for the study. Approval for the study was obtained from the Ethics Committee University of Stellenbosch with reference number N11/04/123, and the Northern Cape Department of Health. The study was carried out between June 2011 and July 2011. The questionnaire was designed based on a publication cited on contraceptive practices of women in Northern Tshwane. Setting: The study was conducted in the ARV clinics of the Kuruman and Tshwaragano districts hospitals and the four community health centres in the John Taolo Gaetsewe Health District. This district is a predominantly rural district. Results: Data was provided by 224 participants who fullfiled the inclusion criteria. The knowledge about condom ranked highest(100%) followed by injectibles(94%), oral contraceptive pills(87%), female sterilization(66%) and emmergency contraception(51%). IUCD is the method that is least known(3%).Nurses are the major source of information about contraceptives(89%) while the educator give the least information to participants on contraceptives(40%). 100% of participants had access to oral contraceptive pills and injectibles at their local clinics while the method that was least accessible are IUCD(2%) and hormonal implants(0%). There was a 100% positive perception of injectibles, 74% to female sterilization 67% for morning after pill and 61% to oral contarecptive pills while male sterilization had a positive perception of 12% and IUCD (8%). Availability of contraceptives influenced choice of contraceptives as participants used available methods at the clinic which were condoms, injectibles, oral contraceptives and female sterilization. Partners of participants and tradition also influenced use while non use was mainly because participant wanted to fall pregnant(22%), side effects(6%) and tuberculosis(1%). Conclusion This study revealed that participants had very good knowledge and positive perception about the readily available contraceptive methods at the local clinics. This was true as 100% were well informed about condoms, 94% about injectibles and 87% about oral contracetive pills. At clinics in John Taolo Gaetsewe health District the three methods of contraceptive mentioned above were what you find readily available. 51% of partcipants were also well informed about emmergency contraception this showed the level of awareness in this area on emmergency contraception despite their low level of education . The study revealed that partners of participants and traditional healer had impact on contraceptive use, while getting pregnant topped the list on reasons why contraceptive was discontinued. Parents, teachers and the media should get more involved in the enlightenment campaign about contraceptive as it will help protect women from unplanned pregnancies.