MAGNITUDE OF UNINTENDED PREGNANCY AND ASSOCIATED FACTORS AMONG HIV POSITIVE PREGNANT AND LACTATING WOMENS ATTENDING PMTCT SERVICE IN MEKELLE PUBLIC HEALTH FACILITY MEKELLE TIGRAY, ETHIOPIA, 2025

Abstract

Background:-Unintended pregnancy is a pregnancy that is untimely or unplanned at the time of conception but may be wanted later. The burden and negative consequences of unintended pregnancy can be severe, especially among women living with HIV. There is a lack of evidence regarding unintended pregnancy among HIV-positive women in the study area. Objective: - To assess the magnitude of unintended pregnancy and associated factors among HIV-positive pregnant and lactating women attending PMTCT services in Mekelle public health facilities, Tigray, Ethiopia, in 2025. Methods and materials: - An institution-based cross-sectional study was conducted from February 1st to April 30th, 2025. A simple random sampling technique was used to select 278 eligible women. Data were collected using a structured, pretested, interviewer-administered questionnaire and chart review. Data were entered into Kobo Toolbox, exported to Excel, and analyzed using SPSS version 27. Independent variables with p < 0.25 were included in the binary logistic regression analysis, and a multivariable logistic regression model was fitted to identify factors associated with unintended pregnancy. Statistical significance was declared based on adjusted odds ratios (AORs) with 95% confidence intervals (CIs) and a p-value ≤ 0.05. . Results:- The magnitude of unintended pregnancy among HIV-positive pregnant and lactating women in Mekelle Town public health facilities was 57.2% (95% CI: 51.3–63.1). Factors significantly associated with unintended pregnancy included primary education (AOR = 12.57; 95% CI: 2.17–72.65), no desire for additional children (AOR = 3.27; 95% CI: 1.48–7.23), and non-disclosure of HIV status (AOR = 3.48; 95% CI: 1.56–12.93). Women with no prior history of unintended pregnancy were significantly less likely to experience it (AOR = 0.12; 95% CI: 0.03–0.50), suggesting that previous experience may enhance awareness and consistent contraceptive use. Conclusion and Recommendations: - Unintended pregnancy remains a major concern among HIV-positive women in Mekelle, influenced by education, HIV disclosure, fertility intentions, and prior pregnancies. Strengthening education, promoting safe disclosure of HIV status, and improving access to family planning services are essential to reduce unintended pregnancies and improve maternal and child health outcomes in this population.