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首页> 外文期刊>International Journal of Reproductive Medicine >Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in Uganda
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Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in Uganda

机译：利用安德森的医疗利用行为模型评估乌干达性活性活性艾滋病毒感染青少年的避孕药

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Background. Contraceptive practices of perinatally HIV-infected adolescents (PHIAs) have implications related to pregnancy prevention, risks of HIV heterosexual transmission, reinfection, and vertical transmission. The study assessed contraceptive use among sexually active PHIAs in Uganda. Methods. Mixed methods consisting of a survey and in-depth interviews were employed among 213 sexually active PHIAs who were attending antiretroviral therapy (ART) clinics. The study was guided by Andersen’s Behavioral Model of Health Service Use as a theoretical framework to identify factors that influence contraceptive use. These factors include health care factors, personal characteristics, enabling factors, and needs. The outcome was contraceptive use. Multivariable logistic regression was used to establish determinants of contraceptive use. Qualitative data were analyzed by thematic analysis. Results. Most PHIAs were female (67.6%); the mean (SD) and median (IQR) age was 17.5 (±1.4) and 18 (17-19) years. The mean age of sexual debut and at marriage were 15 (±1.7) and 17 (±1.1), respectively. Condoms were the most known method of family planning (indicated by 55.4%). Only 16.9% of the participants knew about dual protection (condom use for FP as well as HIV/STI prevention). Of the PHIAs, 43.6% had ever used modern contraception and 56.9% of the females had ever been pregnant. The odds of contraceptive ever-use were significantly higher among adolescents aged 17-19 years (OR 5.1, 95% CI: 2.1-13.3) compared to those aged 10-16 years, those in school (OR 1.8, 95% CI: 1.07-3.2) compared to those out of school, and those with perceived need to use FP (OR 2.0, 95% CI: 1.1-3.9) compared to their counterparts. The odds of contraceptive used were lower among females (OR 0.13, 95% CI: 0.06-0.28) compared to males. From the in-depth interviews, the attitude of health workers, availability of health workers, having a friend using family planning, and waiting time were viewed to affect contraceptive use. Conclusion. Contraceptive use among sexually active perinatally HIV-infected adolescents was (43.6%). However, out of those who used family planning majority were using short-term methods. The unmet need for family planning was high (47%) with high reports of pregnancy (56.9%). The factors associated with contraceptive use included education, age, sex (predisposing factors), and perceived need of family planning (need factors). Other factors that could affect contraceptive use from qualitative analysis included attitude of health workers, availability of health workers, having a friend using family planning (predisposing factors), and waiting time (health system factors). HIV care for adolescents should be promoted using SRH approach. There is a need to provide training for all providers to cater for SRH services. We should continue to provide youth-responsive adolescent sexual and reproductive health services across all ART facilities and build a supportive environment and continue to integrate SRH services into HIV care.
机译：背景。避孕艾滋病毒感染的青少年（Phias）的避孕法实践具有与妊娠预防，HIV异性透射，RENFECT和垂直传输的风险有关的影响。该研究评估了乌干达性活跃的歧视性避孕药。方法。由调查和深入访谈组成的混合方法是在参加抗逆转录病毒治疗（艺术）诊所的213项性活跃的歧视中。该研究由Andersen的卫生服务行为模型作为理论框架指导，以确定影响避孕药的因素。这些因素包括医疗保健因素，个人特征，有利因素和需求。结果是避孕药。多变量逻辑回归用于建立避孕用途的决定因素。通过主题分析分析定性数据。结果。大多数phias是女性（67.6％）;平均值（SD）和中位数（IQR）年龄为17.5（±1.4）和18（17-19）年。性亮相和婚姻的平均年龄分别为15（±1.7）和17（±1.1）。避孕套是最着名的计划生育方法（指出55.4％）。只有16.9％的参与者知道双重保护（CANDOM用于FP以及艾滋病毒/ STI预防）。 Phias，43.6％曾使用过现代避孕，56.9％的女性曾经怀孕过。与学龄前10-16岁（或1.8,95％CI：1.07 -3.2）与学校的相比，与对手相比，有必要使用FP（或2.0,95％CI：1.1-3.9）的人。与雄性相比，女性中使用的避孕药的几率（或0.13,95％：0.06-0.28）较低。从深入的访谈中，卫生工作者的态度，卫生工作者的可用性，使用计划生育的朋友以及等待时间被视为影响避孕药。结论。避孕药在不受流动活性的艾滋病毒感染的青少年（43.6％）。然而，在使用家庭规划多数的人中使用了短期方法。家庭计划的未满足需求高（47％），怀孕报告（56.9％）。与避孕用途相关的因素包括教育，年龄，性别（易感因素），以及计划生育计划（需要因素）。可能影响定性分析避孕药的其他因素包括卫生工作者的态度，卫生工作者的可用性，让朋友使用计划生育（易感因素）和等待时间（卫生系统因素）。使用SRH方法促进青少年的艾滋病毒护理。有必要为所有提供商提供培训，以满足SRH服务。我们应继续在所有艺术设施中提供青少年响应的青少年性和生殖健康服务，并建立一个支持性环境，并继续将SRH服务整合到艾滋病毒护理中。

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