Introduction: As the generalized HIV epidemic in specific settings of sub-Saharan Africa continues
to evolve, there is need for evidence-based response to address emerging challenges,
which include enabling the large number of women living with HIV make informed choices to
achieve their reproductive goals.
Objectives: This paper seeks to (i) examine the effect of HIV/AIDS on contraceptive method
choice among women using contraceptives in Kenya; and (ii) identify correlates of contraceptive
method choice among HIV-positive women practising family planning.
Material and Methods: We apply multinomial Logistic regression models to a sample of 3190
sexually-active women of reproductive age using contraceptives from the 2003 and 2008 Kenya
Demographic and Health Surveys to examine the effect of HIV/AIDS on contraceptive
method choice. The analysis of correlates of method choice among HIV-positive women is
based on a sample of 255 HIV-positive women using contraceptives and involves bivariate
cross-tabulations with Chi-Square tests.
Result: Overall association between HIV status and contraceptive method choice is consistent
with expected patterns, with women who are HIV-positive being more than twice as likely to
use condoms rather than hormonal contraceptives, compared to their counterparts of similar
characteristics who are HIV-negative (p<0.05). Among women infected with HIV, those who
were previously tested for HIV were more likely to use condoms and less likely to use hormonal
methods (p<0.05) than those who had never been tested. The higher use of condoms
by HIV-positive women is only evident among those who had previously been tested for HIV.
Significant correlates of contraceptive method choice among HIV-positive women include parity,
marital status, age group, education and ethnicity. Overall trends suggest a notable shift
from use of hormonal methods to condoms by HIV-positive women, but predominant use of
hormonal methods (60%) and low use of condoms (23%) by HIV-positive young women aged
15-24 practising family planning is of potential concern.
Conclusion: The findings have important implications for family planning policies/programs
targeting young women living with HIV and underscore the need to intensify efforts towards
improved HIV testing coverage to enable HIV-positive women make informed reproductive
choices.