Transportation cost as a barrier to contraceptive use among women initiating treatment for HIV in Tanzania

AIDS Care. 2021 Feb;33(2):206-213. doi: 10.1080/09540121.2020.1758613. Epub 2020 May 6.

Abstract

Transportation cost is a barrier to HIV treatment, yet no studies have examined its association with contraceptive use among women living with HIV. We analyzed cross-sectional data from women attending three public healthcare facilities in Shinyanga, Tanzania where they initiated antiretroviral therapy for HIV infection in the previous 90 days; all facilities offered free contraception. Women self-reported current contraceptive use and the round-trip cost of transportation to the facility. Among 421 women aged 18-49, 86 (20.4%) were using any modern contraceptive method, of which half were using modern methods other than condoms. Women who paid more than 2,000 Tanzanian shillings for transportation had a significantly lower prevalence of any modern method use than women who paid nothing (9.1% vs. 21.3%; adjusted difference: -12.9; 95% confidence interval: -21.3, -4.4). A similar difference was observed for non-condom modern method use. We conclude that high transportation cost may impede contraceptive use even among women accessing HIV treatment.

Keywords: Contraception; HIV; PMTCT; food insecurity; transportation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Condoms / statistics & numerical data
  • Contraception
  • Contraception Behavior / statistics & numerical data*
  • Contraceptive Agents, Female / administration & dosage*
  • Cross-Sectional Studies
  • Female
  • Food Insecurity
  • HIV Infections / drug therapy*
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand
  • Humans
  • Middle Aged
  • Tanzania
  • Transportation / economics*
  • Young Adult

Substances

  • Anti-Retroviral Agents
  • Contraceptive Agents, Female