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AIDS and Behavior

, Volume 23, Issue 6, pp 1431–1451 | Cite as

Unintended Pregnancy in Women Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-analysis

  • Tesfaye Regassa FeyissaEmail author
  • Melissa L. Harris
  • Alemu Sufa Melka
  • Deborah Loxton
Substantive Review

Abstract

In 2014, about 1.5 million pregnancies occurred among HIV-positive women in low and middle-income countries. To pool magnitude and factors associated with unintended pregnancy in women living with HIV in sub-Saharan Africa, a systematic search of electronic databases was undertaken in November 2016. Pooling the magnitude of unintended pregnancy reported by 14 studies yielded a crude summary prevalence of 55.9%. The magnitude of unwanted pregnancy and mistimed pregnancy in six studies ranged from 14 to 59 and 9 to 47.2%, respectively. Contraceptive failure was an important factor for many unintended pregnancies. The magnitude of unintended pregnancy was significantly higher in HIV-positive women than for HIV-negative women in three out of six studies. The available evidence suggests that there is a high magnitude of unintended pregnancy in this population. Improving effective contraceptive utilization is thus a priority to address unintended pregnancies and to prevent mother to child transmission of HIV. PROSPERO Number: CRD42016051310.

Keywords

Unintended pregnancy Unplanned pregnancy Unwanted pregnancy Mistimed pregnancy HIV Women 

Abbreviations

ANC

Antenatal care

ART

Antiretroviral therapy

AOR

Adjusted odds ratio

APR

Adjusted prevalence ratio

CI

Confidence interval

JBI

Johanna Briggs Institute

MeSH

Medical subject headings

OR

Odds ratio

PLHIV

People living with HIV

PMTCT

Prevention of mother to child transmission

WLHIV

Women living with HIV

Notes

Acknowledgements

TRF and ASM are supported by The University of Newcastle International Postgraduate Research Scholarship (UNIPRS) and The University of Newcastle Research Scholarship Central 50:50 (UNRSC 50:50). We are grateful to Hunter Medical Research Institute/Greaves Family Postgraduate Top Up Scholarship (G1701582). We would also like to thank Ryan O’Neill for language edition. Finally, we thank Debbie Booth for supporting in searching.

Author contributions

Contributed to conception and design of the systematic review: TRF, MLH, and DL. Involved in the development of the search strategy, the selection criteria, the strategy for assessment of risk of bias, and data abstraction form: TRF, MLH, and DL. Involved in the screening, assessment of eligibility, selection of studies and critical appraisal as well as data extraction: TRF, MLH, ASM, and DL. Contributed to analysis and interpretation of the data: TRF, MLH, ASM, and DL. Involved in drafting the manuscript and revising it critically: TRF, MLH, ASM, and DL. All authors have given final approval for the manuscript to be published.

Funding

None.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

10461_2018_2346_MOESM1_ESM.docx (97 kb)
Supplementary material 1 (DOCX 97 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Tesfaye Regassa Feyissa
    • 1
    • 2
    Email author
  • Melissa L. Harris
    • 2
  • Alemu Sufa Melka
    • 1
    • 2
  • Deborah Loxton
    • 2
  1. 1.College of Health ScienceWollega UniversityNekemteEthiopia
  2. 2.Research Centre for Generational Health and Ageing, Faculty of Health and MedicineThe University of NewcastleNewcastleAustralia

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