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Dual contraceptive method use in HIV-serodiscordant Kenyan couples
Alison C Roxby1, Leïla Ben-Youssef2,3, Grace Marx4
1Assistant Professor, Departments of Medicine and Global Health, University of Washington, WA, USA.
The Journal of Family Planning and Reproductive Health Care
|February 12, 2016
Summary
Dual contraceptive use was low among Kenyan HIV-serodiscordant couples due to perceived redundancy and focus on conception. Alternative HIV prevention strategies may be more acceptable.
Area of Science:
- Reproductive Health
- HIV Prevention
- Sociomedical Sciences
Background:
- World Health Organization guidelines advocate dual contraceptive methods for HIV/STI prevention and reducing unintended pregnancies.
- This qualitative study explored barriers and motivations for dual contraceptive use in Kenyan HIV-serodiscordant couples.
Purpose of the Study:
- To assess the barriers and motivations influencing dual contraceptive method use among HIV-serodiscordant couples in Kenya.
- To understand contraceptive decision-making dynamics within these couples.
Main Methods:
- Qualitative study involving semistructured interviews with HIV-serodiscordant couples in Nairobi, Kenya.
- Participants included 12 male and 12 female members from serodiscordant cohorts, plus 10 women with incident pregnancies.
Main Results:
- Dual contraceptive use was infrequent; men reported higher condom use than women.
- Contraceptive decisions were male-dominated, influenced by perceived side effects, male preference, and desire for pregnancy.
- Couples viewed dual methods as redundant or indicative of infidelity; accurate fertility awareness was low.
Conclusions:
- Low dual contraceptive use in HIV-serodiscordant couples stems from perceived necessity and a desire to conceive.
- Biomedical HIV prevention strategies (e.g., PrEP, ART) may be more acceptable for safer sex and conception.
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