Prevalence, factors and optimization strategies for contraceptive uptake: A cross-sectional study among adolescents living with HIV at a tertiary hospital in Northern Uganda

Background: In sub-Saharan Africa, contraceptive use among adolescents ranges from 21–42%, with an unmet need of 53–64%. Therefore, client-centered delivery strategies should be explored to improve contraceptive uptake among adolescents living with HIV in Uganda. Methods : An exploratory mixed methods study that was conducted in adolescents living with HIV aged 12-19 years at Gulu Regional Referral hospital in Northern Uganda. Structuredquestionnaires were used to obtain information on contraceptive use, and the most convenient mode of delivery. Selected key informants identified specific delivery strategies potentially associated with higher contraceptive uptake. Results : Of the 193 respondents who participated in the study, 108(56%) were females with a mean age of 15 years. Ever use of modern contraceptives was low at 16% because only a small percentage (approximately 20%) were sexually active. Most participants, 54/193 (40%) preferred accessing contraceptives from the adolescent clinic from health workers and peer supporters. Factors associated with increased contraceptive use were tertiary level education and employment. From qualitative analysis participants recommended the separation of adolescent services, peer support and community outreaches to improve uptake. Conclusion: The contraceptive prevalence rate among HIV-positive adolescents is still low. Contraceptive use is higher among educated or employed adolescents. Services should be provided at adolescent-friendly clinics by trained health workers and peers during school holidays to optimize uptake.