Kusemererwa, Sylvia;
Kansiime, Sheila;
Nakamanya, Sarah;
Mbabazi, Elizabeth;
Fox, Julie;
Mccormack, Sheena;
Kaleebu, Pontiano;
(2024)
Contraceptive use, prevalence and incidence of pregnancy and associated factors among women participating in a vaccine preparedness cohort study in Masaka, Uganda, a retrospective secondary analysis.
Reproductive Health
, 21
(1)
, Article 199. 10.1186/s12978-024-01942-7.
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Abstract
Background: HIV prevention trials usually require that women of childbearing potential use an effective method of contraception. This is because the effect of most investigational products on unborn babies is unknown. We assessed contraceptive use, prevalence and incidence of pregnancy and associated factors among women in a HIV vaccine preparedness study in Masaka, Uganda. Methods: HIV sero-negative women (18–45 years) at high risk of HIV infection identified through HIV counselling and testing (HCT) were recruited between July 2018 and October 2022. Study procedures included collection of baseline socio-demographics and contraceptive use data, quarterly HCT, counselling on and provision of contraceptive methods onsite/through referral, and 6-monthly urine pregnancy tests. Multivariable Logistic and Poisson regression analyses were conducted to determine factors associated with contraceptive use, prevalence, and incidence of pregnancy. Results: 652 (73%) of 891 women reported contraceptive use at baseline. Contraceptive use was higher in women who were in a relationship/married/cohabiting [adjusted odds ratio (aOR) = 1.60; 95% confidence interval (CI) 1.07–2.40] or divorced/separated/widowed [aOR = 1.86; 95% CI 1.24–2.79] versus those that were single, and among women reporting transactional sex [aOR = 2.10; 95% CI 1.16–3.80] versus those who did not. Baseline pregnancy prevalence was 4% (95% CI 3–6%) and lower in women who reported using long-acting contraceptive methods (aOR = 0.17; 95% CI 0.07–0.39) versus women who did not use these methods. A total of 65 pregnancies over 301.3 person-years of observation (PYO), an incidence rate of 21.6/100 (95% CI 16.9–27.5) PYO, higher among younger women (≤ 24 versus 25 + years, adjusted incidence rate ratio = 1.97; 95% CI 1.15–3.40). Conclusion: We observed a high pregnancy incidence in this cohort. Innovative strategies that promote sustained and consistent use of highly effective contraceptive methods especially for young women will be critical to the success of HIV prevention trials in this and similar populations.
| Type: | Article |
|---|---|
| Title: | Contraceptive use, prevalence and incidence of pregnancy and associated factors among women participating in a vaccine preparedness cohort study in Masaka, Uganda, a retrospective secondary analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12978-024-01942-7 |
| Publisher version: | https://doi.org/10.1186/s12978-024-01942-7 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, Contraception, HIV, High risk, Pregnancy, Uganda, HIV PREVENTION TRIALS, PREDICTORS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10212949 |
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