DOI: 10.5061/dryad.182j38r
title: Data from: Consistent condom use among highly effective contraceptive users in an HIV-endemic area in rural Kenya

description: Background: Women of reproductive age are at the highest risk of both HIV
 infection and unintended pregnancy in sub-Saharan Africa. Highly effective
 contraceptives (HECs) such as hormonal injectable and implants are widely
 used in this region. HECs are effective for preventing pregnancies.
 However, unlike condoms, HECs offer no protection against HIV. Dual-method
 use, or the use of condoms with HECs, is an ideal option to reduce HIV
 risk but is infrequently practiced. Rather, women tend not to use condoms
 when they use HECs and increase their HIV risk from their sexual partners.
 However, it remains unknown whether HIV status affects such tendency.
 Given the increasing popularity of HECs in sub-Saharan Africa, this study
 examined the association between the use of HECs and condom use among
 HIV-positive and negative women. Methods: A cross-sectional study was
 conducted among 833 sexually active women aged 18-49 years, recruited from
 six clinics in Siaya county, Kenya. From March to May 2017, female
 research assistants interviewed the women using a structured
 questionnaire. Multiple logistic regression analysis was conducted to
 examine the association between HEC use and consistent condom use in the
 past 90 days, adjusting for potential confounders. It was also examined
 with regular partners (husbands or live-in partners) and non-regular
 partners, separately. In addition, a sub-sample analysis of HIV-negative
 or unknown women was conducted. Results: In total, 735 women were
 available for the analysis. Among the women, 231 (31.4%) were
 HIV-positive. HIV-positive women were more likely to use HECs than
 HIV-negative or status unknown women (70.1% vs. 61.7%, p=0.027). HEC use
 was significantly associated with decreased condom use with a regular
 partner (adjusted odds ratio (AOR)=0.25; 95% CI 0.15-0.43, p&lt;0.001)
 and a non-regular partner (AOR=0.25; 95% CI 0.11-0.58, p=0.001). However,
 compared with HIV-negative or status unknown women, HIV-positive women
 were more likely to use HECs and condoms consistently with a regular
 partner (AOR=6.54, 95% CI 2.15-20.00, p=0.001). Other factors
 significantly associated with consistent condom use included partner’s
 positive attitude toward contraception, partner’s HIV-positive status,
 high HIV risk perception, and desire for children in the future.
 Conclusion: Dual-method use was limited among HIV-negative women and women
 who had HIV-negative partners due to inconsistent condom use. The use of
 HECs was significantly associated with decreased condom use, regardless of
 partner type and their HIV status. Due to this inverse association,
 HIV-negative women may increase their HIV risk from their sexual partners.
 Therefore, interventions should be strengthened to reduce their dual risks
 of HIV infection and unintended pregnancy by promoting dual-method use.
 Family planning services should strengthen counseling on the possible risk
 of HIV infection from their sexual partners and target not only women but
 also their partners, who may play a key role in condom use.
description: Survey data on
 consistent condom use among highly effective contraceptive users in rural
 Kenya A health facility-based cross-sectional study
 was conducted in Siaya county in Kenya. To recruit a sufficient number of
 participants for this study, 73 health facilities were selected from
 across Siaya county, which received more than 500 outpatients per month on
 average in 2015, based on records in the District Health Information
 System. Then, they were clustered into the six sub-counties (Ugenya,
 Ugunja, Alego-Usonga, Gem, Bondo, and Rarieda), and one facility was
 randomly selected per sub-county. Each of the six facilities was allocated
 a sample size proportional to the number of women of reproductive age who
 lived in each sub-county in 2009. Study participants were sexually active
 women aged 18 to 49 who reported having had sexual intercourse at least
 once within 30 days prior to the interview. However, pregnant women and
 women who were sterilized were excluded because they were expected to have
 different reproductive characteristics from other women.
 PLOS_ONE_Data.dta