Socio demographic characteristics
A total of 441 women in reproductive age on ART were enrolled in the study making the response rate 100%.The mean age of the participants were 33.59 + 5.31 years. More than half of them, 256 (58%) were an urban dwellers. Majority of them 404 (91.6%) were orthodox Christians and 430(97.4%) were Amhara in ethnicity. Two hundred forty seven (56%) of the respondents were married. With regard to educational status 139 (31.5%) were illiterate. One hundred forty four (32.7%) of the women were housewives (Table 1).
Communication characteristics of study participant
Among the total 441 participants, 336 (76.2%) knew sero-status of their partner and eighty seven (25.9%) of their partner were sero-positive. One hundred eighty four (41.7%) of the respondents disclose their sero-status for their partners. The main purpose, 253 (57.4%) of disclosing were to support each other. Seventy two (16.3%) of the respondents change their partner because of divorce which is, 44 (61.1%).Two hundred eighty five (64.6%) of the participant believed that, as if contraceptive use might exacerbate HIV disease progression. Three hundred ninety three (89.1%) of the women said that, family planning service charge would affect their contraceptive utilization. Two hundred eighty six (72.8%) of respondents were in support of their spouse on family planning service utilization.
Reproductive and sexual characteristics
Two hundred eighty four (64.4%) had less than five children and 238 (54%) had desire for more children. Additionally, 302 (68.5%) of women had history of sexual intercourse in the last six months and 260(59%) had single sexual partner. Of the study participants 299 (67.8%) of them had information on dual family planning methods and only 46 (19.1%) of them consistently use condom when they experience sexual intercourse (Table 2).
Health facility and clinical factors
Currently 108 (24.5%) of respondents did not use any contraceptive methods. Three hundred forty (77.1%) had ever used modern contraceptives in their life. Injectable was the most preferred method. However, 341 (77.3%) of women had fear of side effects. Sixty two (14.1%) had ever acquire STIs in their life and fifty six (12.7%) seek and got treatment out of the total respondents. Even though, 311 (70.5%) of the family planning was integrated with ART service, 236 (53.5%) of the patient on ART were less than six months duration. About 3/4th of the respondents, 273 (80.0%) respond that, contraceptive use exacerbates HIV disease progression. But, 358 (81.2%) said that distance of their residence could not influence on their contraceptive use (Table 3).
Prevalence of unmet need for family planning
Prevalence of unmet need for family planning was 24.5% with 95% CI (20.4-28.8) with 15.4% for spacing and 9.1% for limiting. The unmet need was composed of pregnant/amenorrheic women and non-pregnant/non amenorrheic women, which was mistimed pregnancy/birth, 12 (2.72%), unwanted pregnancy/birth, 16(3.62%) and those who planned their future pregnancy, want later, 56(12.7%) and want no more, 24(5.4%) There were no women who wanted pregnancy soon. Twenty eight (6.4%) were unplanned pregnancy and 80 (18.1%) were fecund, but were not pregnant and were not have a desire to be pregnant within 2 years.
Factors associated with unmet need for family planning.
In the multivariable logistic regression analysis, residence, age of the women, number of alive children, intention to have more children and ever use of contraception had a statistically significant association with unmet need for family planning.
Women who live in rural place had 2.11 times higher odds of having unmet need for family planning than those who live in urban (AOR: 2.11, 95% CI (1.02, 4.36)). The odds of unmet need for family planning among women in the age group 20-29 was 71% less than those in the age group of 15-24. (AOR: 0.29, 95% CI (0.09, 0.93)). The odds of unmet need for family planning among women in the age group 30-34 was 70% less than those in the age group of 15-24. (AOR: 0.30, 95% CI (0.10, 0.92)). The odds of unmet need for family planning among women in the age group 35-39 was 86% less than those in the age group of 15-24. (AOR: 0.14, 95% CI (0.04, 0.45)). The odds of unmet need for family planning among women in the age group above 40 was 92% less than those in the age group of 15-24. (AOR: 0.08, 95% CI (0.02, 0.38)).The odds of unmet need for family planning among women who have more than three children was 88% less than those who have three and less children (AOR: 0.12, 95% CI (0.04, 0.36)).The odds of unmet need for family planning among women who do not intend to have more children was 92% less than those who intent to have more children (AOR: 0.08, 95% CI (0.03, 0.23)).The odds of unmet need for family planning among women who do not disclose their sero-status to their partner was 61 % less than those who disclose their sero-status (AOR: 0.39, 95% CI (0.19, 0.81)). The odds of unmet need for family planning among women who do not ever use contraception was 56 % less than those who ever used contraception (AOR: 0.44, 95% CI (0.21, 0.92)) (Table 4).