背景:预防艾滋病毒的垂直(母婴)传播是控制艾滋病毒流行的关键策略之一。尽管赞比亚在过去十年取得了相当大的进展,该国尚未达到消除艾滋病毒垂直传播的全球和国家目标。避免感染艾滋病毒的妇女意外怀孕是防止艾滋病毒垂直传播的综合方法中具有成本效益的干预措施之一。因此,本研究旨在确定赞比亚HIV感染妇女计划生育需求未满足的趋势和预测因素.
方法:本研究采用重复横断面(RCS)研究设计,使用2007年、2013/2014年和2018年进行的赞比亚人口与健康调查(ZDHS)最近连续三(3)轮的数据.该研究使用了三个调查期间共有27,153名15-49岁妇女的数据,其中4,113名根据人口和健康调查的严格艾滋病毒检测算法,艾滋病毒呈阳性。这些构成了我们对感染艾滋病毒的女性的样本量。我们使用描述性统计和逻辑回归分析分别确定艾滋病毒感染妇女计划生育需求未满足的趋势和预测因素。
结果:在三个调查点,艾滋病毒携带者中未满足的计划生育需求基本保持不变,从2007年的20.8%到2013/14年的20.5%和2018年的21.1%。Residence,女人的年龄,家庭财富,女人的平价,employment,和配偶年龄成为赞比亚艾滋病毒感染妇女未满足的计划生育需求的重要预测因素。
结论:预防儿童HIV感染可以维持生命,有助于从早期阶段提高生活质量,并避免艾滋病毒治疗的终生成本和相关的医疗保健成本。有必要考虑优化预防艾滋病毒垂直传播的干预措施,包括制定预防艾滋病毒感染妇女意外怀孕的方案。在其他方面,政策和实践需要加强SRH/HIV融合,更好地针对农村居民,年轻女性,考虑男性积极参与,以减少艾滋病毒感染妇女未满足的计划生育需求。
BACKGROUND: Prevention of vertical (mother to child) transmission of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress over the past decade in Zambia, the country is yet to reach global and national target for elimination of vertical transmission of HIV. Avoidance of unintended pregnancy among women living with HIV is one of the cost-effective interventions in a comprehensive approach to prevent vertical transmission of HIV. Therefore, this study aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia.
METHODS: The study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 27,153 women aged 15-49 years over the three survey periods among whom 4,113 had an HIV positive result following a rigorous HIV testing algorithm of the demographic and health surveys, and these constituted our sample size of women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among women living with HIV.
RESULTS: Over the three survey points, unmet need for family planning among women living with HIV has largely remained unchanged from 20.8% in 2007 to 20.5% in 2013/14 and 21.1% in 2018 DHS. Residence, age of women, household wealth, woman\'s parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia.
CONCLUSIONS: Preventing HIV infection in a child preserves life, contributes to improving quality of life from its early stages and averts lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of interventions to prevent vertical transmission of HIV including shaping programming regarding preventing unintended pregnancies among women living with HIV. Among other aspects, policy and practice need to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV.