Background: About 22.4 million people were living with HIV/AIDS in 2008 out of which
women constitute approximately 57%. Namibia is one of the highly affected countries with a
national HIV prevalence of 17.8% among women attending antenatal clinics. Antiretroviral
medications have become available in Namibia since 2002 and presently all district hospitals
and some health centres provide ARVs to those in need. Namibia is rated as one of the few
countries in sub-Sahara Africa with a high coverage of ART, with 80% of those in need of
ART receiving the treatment. An increasing trend has been observed whereby HIV+ women
on ARV are becoming pregnant. Little is known about the attitude, knowledge and behavior
of these women towards family planning and use of contraceptives and what barriers they
may be facing in accessing these services.
Aim: To determine the factors affecting the utilization of family planning services by HIV+
pregnant women receiving PMTCT services.
Methodology: The study was a cross sectional study using both quantitative and qualitative
methods to assess the critical elements of knowledge, attitude and perceptions of the study
participants towards family planning services. The study also assessed the health system and
other factors that impact on the use of contraceptives by HIV+ women. It was conducted in
northern Namibia at Oshakati Health centre among randomly selected pregnant HIV+ women
attending for PMTCT services.
Results: Among the 113 respondents, who participated in the study, 97.3% knew at least one
method of family planning but only 53.6% actually used any method of contraception prior to
current pregnancy. Among the 46.4% who did not use any contraception, the reasons often
cited for non-use were because they wanted a baby (52%), spouse objection (10%), being
afraid of the effects (14%) and other reasons such as belief, culture and distance to travel to
the health facility. 88% of the respondents indicated a willingness to use contraceptives after
current pregnancy and expressed general satisfaction with services at the health centre while
asking for more information on family planning services.
iv
Conclusion: HIV+ women have high awareness on some contraceptives but use of
contraceptives is not as high as many of them have a desire to have children for self esteem
and leave a legacy for the future. Knowledge of the risks of pregnancy on HIV+ woman may
be limited and there is a need to improve educational intervention in this regard as well as
integrate family planning services into all HIV/AIDS services.