Factors Influencing Pregnancy-Preparedness By Hiv Positive Women In Seme Sub-County, Kenya

ABSTRACT

Pregnancy preparedness is a precautionary measure for readiness to conceive. It encompasses readiness of a health provider and HIV positive women to contain possible risk factors for mother-to-child HIV transmission. It also includes assessment of pregnancy status, pregnancy intentions, contraceptive status and a suppressed viral load for HIV positive women. Despite the high prevalence of pregnant HIV positive women in Seme Sub-County, the factors influencing pregnancy-preparedness had not been determined. The purpose of this study was to assess factors affecting pregnancy preparedness among HIV positive women in Seme Sub-County. Specifically to determine the level of preparedness, establish demographic factors, identify partner characteristics and to determine health facility-factors influencing pregnancy preparedness among HIV positive women in Seme Sub-County. A cross sectional study was conducted in 24 public health facilities in Seme Sub-County using a sample size of 132 from a target population of 200. Data was collected using questionnaires, while 10 clinicians were utilized as key informants. Frequency and percentages were used to determine the level, assess demographic factors, identify partner characteristics and assess health facility factors. Bivariate logistic regression analyses were used to test the association between demographic factors, partner characteristics and health facility factors and pregnancy preparedness. The study found that 60(45.5%) of the respondents were prepared while 72(54.5%) were unprepared. Women aged 25-34 and 35-44 years were more likely to be prepared for their pregnancies (OR=1.189, 95%CI=1.08–1.7 and OR=1.08, 95%CI=0.064–1.736 respectively), compared to younger women. Women with post-secondary school level of education were more likely to prepare better (OR=11.4; 95%CI =7.72–17.02) than those with lower levels. HIV positive women who had disclosed their HIV status were more likely to be prepared (OR=2.83;95%CI=1.113–5.269). Prior use of contraceptives as part of HIV care was associated with better preparedness compared to non-usage (OR=1.914;95%CI=1.511–4.672). HIV positive pregnant women on and adhering to ART were more likely to be prepared (OR=2.97;95%CI =1.245– 4.669) compared to those who did not initiate and adhere to ART. There is need for health care facility providers to pay more attention to young HIV positive women in terms of pregnancy preparedness. National and county government should emphasize the interventions aimed at reducing intimate partner violence. There is need to promote HIV status disclosure among women living with HIV to promote optimal pregnancy preparedness by HIV positive women. Clinicians and other health care providers should optimize the utilization of the Ministry of Health standard Reproductive Health Screening tool for women on ART as a way of strengthening health facility factors for pregnancy preparedness.