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
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 a...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-12-01
|
| Series: | Reproductive Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12978-024-01942-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850103165733568512 |
|---|---|
| author | Sylvia Kusemererwa Sheila Kansiime Sarah Nakamanya Elizabeth Mbabazi Julie Fox Sheena McCormack Pontiano Kaleebu Eugene Ruzagira |
| author_facet | Sylvia Kusemererwa Sheila Kansiime Sarah Nakamanya Elizabeth Mbabazi Julie Fox Sheena McCormack Pontiano Kaleebu Eugene Ruzagira |
| author_sort | Sylvia Kusemererwa |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3295062445c6427dbecbb5fe4c2c845b |
| institution | DOAJ |
| issn | 1742-4755 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj-art-3295062445c6427dbecbb5fe4c2c845b2025-08-20T02:39:37ZengBMCReproductive Health1742-47552024-12-0121111010.1186/s12978-024-01942-7Contraceptive use, prevalence and incidence of pregnancy and associated factors among women participating in a vaccine preparedness cohort study in Masaka, Uganda, a retrospective secondary analysisSylvia Kusemererwa0Sheila Kansiime1Sarah Nakamanya2Elizabeth Mbabazi3Julie Fox4Sheena McCormack5Pontiano Kaleebu6Eugene Ruzagira7Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitKing’s College LondonMedical Research Council Clinical Trials UnitMedical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research UnitAbstract 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.https://doi.org/10.1186/s12978-024-01942-7ContraceptionHIVHigh riskPregnancyUganda |
| spellingShingle | Sylvia Kusemererwa Sheila Kansiime Sarah Nakamanya Elizabeth Mbabazi Julie Fox Sheena McCormack Pontiano Kaleebu Eugene Ruzagira 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 Contraception HIV High risk Pregnancy Uganda |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Contraception HIV High risk Pregnancy Uganda |
| url | https://doi.org/10.1186/s12978-024-01942-7 |
| work_keys_str_mv | AT sylviakusemererwa contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT sheilakansiime contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT sarahnakamanya contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT elizabethmbabazi contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT juliefox contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT sheenamccormack contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT pontianokaleebu contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis AT eugeneruzagira contraceptiveuseprevalenceandincidenceofpregnancyandassociatedfactorsamongwomenparticipatinginavaccinepreparednesscohortstudyinmasakaugandaaretrospectivesecondaryanalysis |