Factors associated with family planning use among sexually active young (15–24 Years) people living with HIV in Kampala City, Uganda

Abstract

Background: Family planning (FP) is crucial for enabling young people to reach their full potential by preventing the health, social, and economic impacts of unplanned pregnancies. Despite its importance, FP use among sexually active young people living with HIV (YPLWHIV) remains low. This study investigates the prevalence, unmet need, and factors associated with FP use among YPLWHIV in Kampala City, Uganda. Methods: This cross-sectional study enrolled 492 YPLWHIV from eight purposively selected health facilities in Kampala City between September 2023 and January 2024. Data were collected using a pretested semi-structured questionnaire. The prevalence of FP use and unmet need were calculated as proportions, and modified Poisson regression was used to identify factors associated with FP use. Results: The median age of study participants was 23 years, range 16-24 years. Most (69.5%) were female. More than half (53.0%) had attained secondary level education and 33.1% were married/cohabiting. The prevalence of FP use was 85.7% among female respondents and 79.3% among male respondents while the unmet need for FP was 10.5%. The most common FP methods were injectables (35.9%), male condoms (30.0%), and implants (20.2%). Traditional methods were used by 12.6% of participants. Awareness of FP methods was positively associated with FP use for both females (adjusted prevalence ratio [aPR]=1.33, CI=1.17-1.52) and males (aPR=1.28, CI=1.11-1.47). Female YPLWHIV living with parents/guardians had 8% lower prevalence of FP use compared to those living alone (aPR=0.92, CI=0.86-0.98). Males living with their sexual partners had 1% higher prevalence than those living alone (aPR=1.01, CI=1.00-1.01). Among females, each additional child increased the prevalence of FP use by 3% (aPR=1.03, CI=1.01-1.06), and each additional sexual partner in the past month increased it by 1% (aPR=1.01, CI=1.00-1.01). Discussion of FP with partners was linked to a 7% increase in prevalence (aPR=1.07, CI=1.01-1.12). Among males, being older by one year was inversely related to FP use (aPR=0.98, CI=0.96-0.99), while later age at coitarche correlated with a 4% increase in FP use (aPR=1.04, CI=1.02-1.06). Conclusion: Despite a high prevalence of FP use, significant unmet need persists among YPLWHIV. Enhancing knowledge and awareness of FP, alongside promoting open discussions between partners, is essential to increasing FP utilization among YPLWHIV.