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首页> 外文期刊>Sexually Transmitted Infections >Reliance on condoms for contraceptive protection among HIV care and treatment clients: A mixed methods study on contraceptive choice and motivation within a generalised epidemic
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Reliance on condoms for contraceptive protection among HIV care and treatment clients: A mixed methods study on contraceptive choice and motivation within a generalised epidemic

机译：依靠避孕套在HIV护理和治疗客户中提供避孕保护：在广泛流行的情况下避孕选择和动机的混合方法研究

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Objectives: To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods: Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results: 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identi fied motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions: Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs.
机译：目标：（i）描述斯威士兰曼齐尼（Manzini）HIV护理和治疗（HCTx）客户的避孕措施，包括他们未满足的计划生育（FP）需求，并将其与人口水平的估计进行比较; （ii）定性探索影响避孕选择和使用的因果因素。方法：采用定量和定性混合的方法。在HCTx客户（N = 611）中进行的横断面调查调查了FP和避孕套的使用方式。使用描述性统计数据，将调查结果与从斯威士兰人口与健康调查数据中得出的人口水平估计值进行比较，并进行加权加权。与HCTx提供者（n = 16）和客户（n = 22）进行了深入访谈，并进行了专题分析。结果：64％的HCTx客户报告了目前的避孕药具使用情况;大多数人只依靠避孕套，很少实践双重使用方法。 HCTx女性患者中FP的避孕套使用率（77％，95％CI为71％至82％）高于研究区域的人口水平估计值（50％HIV阳性，95％CI为43％至57％; 37％HIV阴性，95％CI 31％至43％）;当考虑使用安全套的一致性时，未满足的FP需求率相似（32％HCTx，95％CI 26％至37％; 35％HIV阳性，95％CI 28％至43％; 29％HIV阴性， 95％CI为24％至35％）。定性分析确定了影响FP选择的动机因素：对再次感染的恐惧;对艾滋病毒感染者使用避孕套的方案重点;在开始抗逆转录病毒治疗（ART）之前和之后改变性行为;没有向合作伙伴披露;和避孕副作用的恐惧。结论：对再感染的恐惧超过了考虑怀孕风险的考虑。根据当前关于再感染的证据，HCTx服务必须不仅仅局限于促进避孕套的推广，尤其是对于那些具有血清调和性关系的人，还必须考虑满足生殖需求的多种策略。

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