Contraceptive need and use among individuals with HIV/AIDS living in the slums of Nairobi, Kenya

OBJECTIVE: To understand contraceptive need and use among individuals with HIV/AIDS living in slums. METHODS: A sequential mixed-methods study was conducted in two slums in Nairobi, Kenya, from November 6th, 2009 to April 18th, 2010. Data were obtained by quantitative survey (n = 513), qualitative in-depth interviews (n = 41), and key informant interviews (n = 14). RESULTS: In all, 250 (55.5%) participants used contraceptives. Condoms were the most frequently reported modern method (n = 142; 60.4%), followed by injectables (n = 55; 23.4%) and dual methods (n = 38; 15.3%). Unmet need was reported by 151 (33.6%) individuals. Factors associated with contraceptive use were education, marital status, number of living children, discussion of contraception with a provider, and social support. Personal, conceptual, and structural barriers to contraceptive use were identified. CONCLUSIONS: Individuals with HIV/AIDS wished to limit their fertility but experienced high unmet need for contraception. Multi-level interventions, including educational campaigns and integration of HIV and family planning services, are required to overcome barriers.