Contraceptive failure prediction framework: A veritable tool for reducing incidence of unintended pregnancies among HIV-positive women.

Abstract

Contraceptive failure remains a global public health challenge among HIV positive women. Therefore, this study aimed to propose a contraceptive failure prediction framework based on the findings from HIV-positive women of reproductive age in South Africa and the perception of their healthcare providers. A mixed-methods approach was utilized, with participants purposively selected based on their knowledge and experiences. Qualitative data gathered from two focus group discussions (FGDs) involving seven (n = 7) healthcare workers (HCWs) and in-depth interviews involving ten (n = 10) HIV-positive women as well as quantitative data comprising a cohort of one hundred and seventy-three (n = 173) HIV-positive women who participated in the South African National HIV Prevalence, Incidence, Behavior Survey (SABSSM) were used to identify contraceptive failure determinants. Participant demographic information was analyzed using descriptive statistics, while inferential analysis was done using multiple regression statistics. The qualitative data were thematically analyzed. Healthcare workers' (HCWs') support, knowledge of contraceptive use, access to preferred contraceptives, and income collectively predicted contraceptive failure. These findings facilitated the development of a Contraceptive Failure Prediction Framework (CFPF), interpreted here as a determinants framework.