Contraceptive Use and Associated Factors Among People Living with HIV/AIDS Attending an Anti-Retroviral Therapy Centre in Central India

Abstract

Introduction:

India is home to approximately 2.47 million people living with HIV (PLHIV), and the increasing availability of

antiretroviral therapy (ART) has contributed to a decline in AIDS-related mortality. However, unintended

pregnancies among PLHIV continue to pose a public health challenge. While ART services are well-established, the

integration of family planning (FP) services remains suboptimal, particularly for individuals outside key populations.

This study aimed to assess patterns of contraceptive usage and explore associated socio-demographic and clinical

factors among PLHIV in Central India.

Methods

A cross-sectional study was conducted among 168 HIV-positive individuals attending the ART Centre to evaluate

changes in contraceptive use before and after HIV diagnosis, identify factors influencing current use, and explore

key barriers among non-users. Participants were selected using purposive sampling and interviewed using a

structured, pre-tested questionnaire. Data were analysed using SPSS version 25, applying descriptive statistics and

chi-square tests to examine associations, with a p-value of < 0.05 considered statistically significant.

Results

Contraceptive use increased significantly after HIV diagnosis, rising from 35.1% to 78.0%. Condoms remained the

most used method both before and after diagnosis. Additionally, the use of oral pills, copper-T, injectables, and

natural methods increased post-diagnosis, indicating diversification of contraceptive methods. Education (p =

0.021) and spouse’s HIV status (p = 0.03) were significantly associated with current contraceptive use. Among non

users, key barriers included irregular sexual activity (43.2%), partner discordance (27%), and fear of side effects

(10.8%).

Conclusion

The study highlights a promising increase in contraceptive uptake among PLHIV following diagnosis. However,

persistent barriers and limited method choices underscore the need for integrated, client-centred FP services within

ART centres. Addressing misinformation, involving partners, and strengthening education-focused counselling

could contribute to improved contraceptive outcomes for PLHIV.