Dr Anire Chima-Oduko, a researcher at the Lagos University Teaching Hospital, has urged immediate improvements in reproductive health services for women living with HIV, citing significant gaps in access, quality of care, and contraceptive uptake.
Speaking in Lagos on Wednesday, she presented findings from a study on pregnancy intentions and contraceptive needs among women living with HIV. The research, co-led by Prof Mobolanle Balogun and funded by the Royal Society of Tropical Medicine and Hygiene, highlights how service limitations are contributing to a high rate of unintended pregnancies.
“The findings reveal a pressing need to strengthen reproductive health services for women living with HIV,” Dr Chima-Oduko said. “Addressing gaps in access, quality, and provider communication is critical to improving outcomes.”
The study found that awareness of contraception among respondents was high, with 97 per cent having heard of it and 94.6 per cent correctly defining it as a method of preventing pregnancy. However, utilisation remains low. While 63.3 per cent had ever used contraceptives, only 26.8 per cent are current users, indicating unmet contraceptive needs despite widespread awareness.
Key factors influencing contraceptive use included the number of children, the partner’s HIV status, and access to family planning services. Women who knew their partner’s HIV status and those with more children were significantly more likely to use contraception. Access to services and discussions with healthcare providers also played a major role.
Dr Chima-Oduko stressed that provider-client communication remains a major gap in service delivery. “Women who did not receive adequate counselling were less likely to use contraceptives. This reflects missed opportunities during routine clinic visits,” she explained.
The findings also revealed diverse fertility intentions among women living with HIV, with many still desiring children while others prefer to limit childbearing. “Women’s reproductive goals are not uniform. Yet, the high prevalence of unintended pregnancies shows a disconnect between intentions and effective contraceptive use,” she noted.
Systemic challenges identified included limited access to family planning services, misinformation, and perceived inadequacy of care. “Even within tertiary facilities, access is not optimal, and quality of care varies. This suggests structural barriers and gaps in service delivery,” she said.
To address these challenges, Dr Chima-Oduko recommended a multi-level approach, including improving access to family planning, strengthening routine counselling, enhancing service quality, and addressing misinformation. “We must adopt client-centred approaches that align services with women’s reproductive intentions. Improving communication and ensuring consistent access to quality services will increase contraceptive uptake,” she said.
She added that integrating reproductive health services within HIV care and routinely assessing women’s fertility intentions would help bridge existing gaps. “Strengthening reproductive health services is essential to reducing unintended pregnancies and improving overall health outcomes for women living with HIV,” she concluded.
