Research consultancy
CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction
This chapter presents a review of existing literature on factors influencing family planning (FP) use among HIV-positive mothers, as documented by various scholars. The discussion is structured according to the study’s specific objectives: socioeconomic factors, knowledge, and individual-related factors.
2.2 Socioeconomic Factors Influencing Family Planning Uptake Among HIV-Positive Mothers
Research on the impact of antiretroviral therapy (ART) on pregnancy rates among HIV-infected women in sub-Saharan Africa found that women receiving ART had an 80% higher likelihood of pregnancy compared to those not on treatment. Additional factors linked to increased pregnancy risk included younger age, lower education levels, marital status, cohabitation, and non-use of non-barrier contraception (Myer et al., 2010).
Preventing unintended pregnancies in HIV-positive women is essential for eliminating mother-to-child transmission (eMTCT) and aligns with global health standards. Ensuring access to reproductive health services enables informed decision-making and contraceptive use, thereby reducing infant HIV infections (MOH Uganda, 2012).
FP helps HIV-positive women avoid high-risk and unintended pregnancies, which may otherwise lead to unsafe abortions and complications like puerperal sepsis (WHO, 2009). However, some HIV-positive women who do not desire children avoid FP due to perceived side effects (e.g., irregular bleeding) or concerns about combining contraceptives with ARVs (MOH/ACP, 2012).
Cultural expectations, such as pressure to bear children—particularly male heirs—and the value placed on large families, further influence reproductive decisions among HIV-positive women (Beyeza-Kashesya, 2009; Nattabi, 2009).
2.3 Knowledge of HIV-Positive Mothers on Family Planning Methods
A South African study comparing FP use between HIV-positive and HIV-negative women found that HIV-positive women had higher pregnancy desires but lower condom and contraceptive use (Peltzer et al., 2009). Conversely, research in Uganda’s Kabarole District indicated that HIV-positive women were 6.25 times more likely to limit childbearing due to awareness of MTCT risks (Hey et al., 2011).
Despite this awareness, some HIV-positive women still pursue pregnancy, highlighting the need to respect their reproductive rights (Ikerra, 2014). UNAIDS (2010) notes that gender disparities often hinder women’s ability to negotiate condom use, increasing exposure to HIV and STIs.
