Utilization of Preconception Care, and Associated Factors Among HIV Positive Reproductive Age Women Attending Art Clinics at Gamo Zone Government Health Institutions Southern Ethiopia, 2020

Utilization of Preconception Care, and Associated Factors Among HIV Positive Reproductive Age Women Attending Art Clinics at Gamo Zone Government Health Institutions Southern Ethiopia, 2020 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Utilization of Preconception Care, and Associated Factors Among HIV Positive Reproductive Age Women Attending Art Clinics at Gamo Zone Government Health Institutions Southern Ethiopia, 2020 Melkamu Tulbake, Birknesh Mereta, Eyasu Ware, Tadele Damena This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9505909/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background: Preconception care is specialized care targeted at women of reproductive age before and between pregnancies to increase the chance of having a healthy baby and being a healthy mother. The prevalence of preconception care in HIV-positive women was low which increase the vertical transmission of the Human Immune Deficiency Virus and adverse birth outcomes. Objective ፡ To assess utilization of preconception care and associated factors among Human Immune Deficiency Virus positive reproductive age women attending Anti-Retroviral Treatment clinics in Gamo zone 2020/2021 Method: Institution-based cross-sectional study was conducted fromMarch20-May132021. 559 study participants were selected by simple random sampling technique. Data were collected using Structured, pre-tested, interviewer-administered questionnaires, then coded and entered into Epi data 3.1 and exported to SPSS version 25 for cleaning and analysis. In bivariate analysisvariables with a P-value < 0.25 were transferred to multivariate analysisand a P-value of < 0.05 with 95%, CI is considered for the presence of a statistically significant association. Result: A total of 559 HIV-positive women participated with a response rate of 97.9% .over all utilization of preconception care was32%. Education, Monthly income,History of pregnancy, Number of pregnancyand Occupation were significantly associated with utilization of preconception care with (AOR: 4.42; 95%CI: 1.48, 13.17), (AOR: 2.85; 95% CI 1.41, 5.74), (AOR: 2.99; 95% CI 1.18, 7.71), (AOR: 2.97; 95% CI 1.28, 6.91), and(AOR: 0.45; 95% CI 0.21, 0.96) respectively. Conclusion : prevalence of preconception care among HIV-positive women was law. Educational status, occupation, monthly income, history of pregnancy, and several pregnancies were factors associated with utilization of preconception care. All stakeholders should work together to address the identified problems. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors Preconception care utilization human immune deficiency virus Gamo zone Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 INTRODUCTION Preconception care is the provision of biomedical, behavioral, and social health interventions to women and couples prior to conception with the goal of enhancing their health and lowering behaviors and environmental or individual factors that may lead to poor health outcomes for mothers and children ( 1 ). Six months prior to conception, preconception care offers a chance to change harmful habits early on, which may have a long-term favorable impact on the mother's and the child's (future) health outcomes ( 2 , 3 ). A number of international groups and organizations representing health professionals and policymakers have recognized the significance of this aspect of modern health care. It pertains to care prior to pregnancy, whether it be the first pregnancy or in between subsequent pregnancies ( 4 ). As part of standard primary care, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and other national organizations advise providing comprehensive family planning and preconception counseling and care to all women of childbearing age ( 5 , 6 ). Preconception care and counseling must be included in primary care settings in order to avoid unwanted pregnancies, safeguard the health of the mother and fetus during pregnancy, stop HIV transmission during pregnancy, and lower the risk of HIV transmission to uninfected partners ( 7 ). The World Health Organization recommends that the preconception care package address the following areas: tobacco use, genetic conditions, environmental health, infertility/subfertility, interpersonal violence, too-early, unwanted, and rapid successive pregnancies, sexually transmitted infections, human immune deficiency virus, mental health, and nutritional conditions (screening for anemia and diabetes, supplementing iron and folic acid, information, education, and counseling and monitoring nutritional status) ( 1 , 2 ). Preconception care for women living with HIV aims to prevent unwanted pregnancy, improve maternal and fetal outcomes during pregnancy, optimize maternal health prior to pregnancy, prevent HIV transmission during pregnancy, and prevent HIV transmission to an uninfected sexual partner when attempting to conceive ( 8 , 9 ) Preconception care is equally important for HIV-positive women and should be part of standard HIV medical care. This includes talking about safe sex to prevent STIs and unwanted pregnancy, risk factors for prenatal transmission, the effects of antiretroviral medications on hormonal contraception, the effects of medication on a fetus should pregnancy occur, and vaccination as needed ( 10 ) All women of reproductive age who are known to be HIV positive should get preconception care and counseling. Maternal virology and immunologic status, the timing and selection of antiretroviral medication (which must consider the possibility of pregnancy), education about the risk of prenatal transmission, and intervention techniques must all be included in such counseling ( 9 , 11 ) Research revealed that preconception care is somewhat more common in industrialized nations than in developing nations, such as Ethiopia, since its goals and objectives are not widely recognized and understood in low-income nations. Knowledge of preconception care, sociodemographic, economic, and obstetric considerations, family planning history, and service availability and accessibility all had an impact on preconception care (27, 28.30). Preconception care has a greater contribution to have a healthy pregnancy, and it has better importance in those HIV-positive women. Thus this study will assess utilization of preconception care and associated factors among HIV-positive reproductive age group women. (Fig. 1 ) Figure 1 : Conceptual framework for the study utilization of preconception care and associated factors among HIV positive reproductive age women in the art ART clinics METHODS AND MATERIALS Study area and period The study was conducted in the Gamo zone of SNNPR. It has 14 woredas and one zonal town. The total population is 1,580,000 out of which 837,400 are females. Among this 368,140 (23.3%) females are under the reproductive age category. 3243 adults are on ART; among those 1728 are women of reproductive age. There are 4 primary hospitals and one general hospital, 57 health centers, 299 health posts, and also, private facilities are found in the zone. Three hospitals and ten health centers provide ART services in Gammo Zone.Arbaminch town is the zonal town of the Gamo zone which is located 505 km from Addis Ababa, the capital city of Ethiopia, and 227 Km from Hawasa the regional capital city of SNNPR. The study was conducted from March 1- April 1, 2021. Study design A facility-based cross-sectional study was conducted. Population Source population All HIV-positive women of reproductive age group attending ART clinics in theGamo zone governmental health facilities Study population : all selectedHIV-positive women of reproductive age attending ART clinics in theGamo zone government health facilities during the study period Eligibility criteria Inclusion criteria HIV-positive women of reproductive age attending ART clinics in the public health institution during the study period without considering marital and pregnancy status Exclusion criteria critically ill HIV-positive reproductive-age women who cannot communicate attending ART clinics in the selected public health institutions during the study period SAMPLE SIZE DETERMINATION There is no study in a similar setting to this study. Thus we calculate for both objectives by the following assumption. For the first objective Single population proportion formula was used on the assumption of 50% prevalence (p) of preconception care among HIV-positive reproductive-age women. 95% confidence interval (Za), 5% marginal error (d), n = 384; For second by using two populations proportion by the following assumptions: level of confidence of 95%, power = 80%, the ratio of exposed to unexposed three. Percent of outcome among exposed 20 and percent among non-exposed 10%. By the assumptions, 138 exposed 413 unexposed, and 551calculated. Thus we select 551 to get an adequate sample size for both specific objectives and add nonresponse 5%( 28) 579. SAMPLING PROCEDURE There are three hospitals and ten health centers that provide ART services in the Gamo zone. There are a total of 1728 HIV-positive women of reproductive age attending ART clinicsof government health institutions within one month period. In the study, all three hospitals and four out of the health center are included by using simple random sampling. Then prepare lists of patients to have an appointment in the data collection period. After preparing an updated list of HIV-positive reproductive age women sample was allocated by the proportional allocation method for each hospital. Finally, eligible study participants were taken by a computer generating simple random sampling method (Fig. 2 ) Figure 2 :Schematic presentation of the Sampling procedure for the study utilization of preconception care and associated factors among HIV positive reproductive-age women in Gamo zone STUDY VARIABLES Dependent variables Utilization of preconception care Independent variables Knowledge on preconception care - Information on preconception care and level of knowledge Socio-demographic factors Age , marital status, educational status of the mother, occupation, and educational status of the husband, occupation of husband, monthly income, and family size. Obstetric factor Parity, gravidity, history of (abortion, stillbirth, congenital anomaly, and neonatal death), history of contraceptive use. Facility related factors Availability of PCC service provision room, Availability of adequate laboratory service availability of adequate medication. OPERATIONAL DEFINITION Preconception care Any interventions either advice or treatment, and lifestyle modification before being pregnant. (Preconception care components in this study are, HIV(male partner testing, promote the safer sexual practice, ART and planning a pregnancy and assess plasma viral load, family planning, STI screening and treatment, Nutrition, Ferrous supplementation, Immunization, Advice on cessation of alcohol, Advice on cessation of cigarette smoking)( 12 , 13 ) Knowledge on preconception care: is information by which an HIV-positive reproductive age woman has about preconception care ( 12 ). Good knowledge Those who have scored above or equal to the mean score of correct respond to preconception knowledge questions. Poor knowledge Those who have scored less than the mean score of correct responses to preconception care knowledge questions. Utilization of preconception care if a woman receives any intervention either advice or treatment and lifestyle modification before being pregnant. The level of utilization of preconception care was measured using clients‟ responses about any intervention either advice or treatment and lifestyle modification regarding components of preconception care. Data collection procedures The interviewer-administered questionnaire was used to collect the data; data was collected by 8 trained health care providers and three supervisors through face to face interview method using a pre-tested and structured questionnaire. The questionnaire contains five parts including socioeconomic and demographic characteristics, obstetrics factors, Knowledge related factors, utilization, and facility-related factors of PCC. Confidentiality of information, respondent’s rights, informed consent, and technique of interview supported with communication and discussion every day with the supervisors and data collectors about the problem faced were made during the data collection process. Data quality management/Assurance Various activities were performed to assure the quality of data. The English version questionnaire would be translated into Amharic by a person knowing both of the languages. The principal investigator and supervisors were frequently supervising the data collection process by checking the completeness of the required type of data to correct faults if any on the site of data collection. Proper training was givento the interviewers and supervisors of the data collection procedures, proper categorization, and coding of the questionnaire. The quality of data was assured by properly designing and pre-testing the questionnaire, the questionnaire was pre-tested on (5% of total sample size) respondents in health institutions that had similar characteristics with the study population. Every day, all the completed questionnaires were reviewed and checked for completeness and relevance by the supervisors and every other day by the principal investigator, and all the necessary feedback was offered to data collectors the next morning before the actual procedure. Ethical Approval and Informed Consent All methods were carried out in accordance with relevant guidelines and regulations. The study protocol was approved by Arba Minch health science college, Approval No. Amchs/01/20/7036. Informed consent was obtained from all participants prior to participation. Participation was voluntary, confidentiality was maintained, and participants could withdraw at any time without consequence. DATA PROCESSING AND ANALYSIS Data were entered by using Epi data version 3.1 and exported to SPSS statistical software package version 25 for data cleaning and analysis. During analysis the variables are defined, categorized, and recoded, then frequencies and percentage of the different variables were computed. The bivariate analysis was used primarily to check which variables had an association with the dependent variable individually and multivariable logistic regression was conducted to analyze factors that have an independent association with the utilization of preconception care. All variables were found to be associated with the main outcome variables with 95% CI in the bi-variate model i, e. P-Value < 0.25 and other important variables from other Studies will be a candidate for the multivariable model analysis, and variables having an independent association with outcome variable at P-value < 0.05 was considered as statistically significant. RESULT Socio-demographic characteristics of Respondents A total of 559 reproductive-age women participated in this study with a response rate of 97.90%. The age of the study participants ranged from 15to 48 years with a mean age of 32.52 ± 7.439 SD and two hundred ninety-one (51.2%)of respondents were married. The mean monthly income was 3333.34 while 144(31.3%) studied participants earn less than 1000 ETB. Occupations of the respondents and the rest were also mentioned in the table below. (Table 1 ). Table 1 Socio-Demographic Characteristics of Respondents for preconception care among reproductive-age women attending ART clinic at Gamo zone government health institution, South Ethiopia, 2021 (N = 559) Variable Frequency Percent (%) Age in year 15–24 78 14.0 25–34 235 42.0 35–49 246 44.0 Marital status Married 291 52.1 Single 79 14.1 Divorce 99 17.7 Widowed 90 16.1 Educational status of the respondent no read write 118 21.1 Read-write only 95 17.0 Primary 135 24.2 Secondary 139 24.9 College and above 72 12.9 Occupation of respondent Government employ 82 14.7 Private employ 178 31.8 Student 67 12.0 Housewife 174 31.1 NG Employ 58 10.4 Educational status of husband No read write 43 14.8 Read-write only 36 12.4 Primary 69 23.7 Secondary 70 24.1 College and above 73 25.1 Occupation of husband Government employ 82 28.2 Private employ 86 29.6 Student 14 4.8 NG Employ 5 1.7 Daily laborer 91 31.3 Farmer 13 4.5 Total house hold Monthly income in ETB 10000 15 3.3 Family size 4 196 35.1 Knowledge of respondents towards preconception care Of the total of 559 participants, 286 (51.2%) of women have information about preconception care before. Of those who have information; health professionals were the major source of information 222 (75.3%) followed by media 74 (25.1%), friends 45(15.2%), and from families 23(7.7%). Based on the PCC component questions response 123(43%) of women have good knowledge of PCC. (Fig. 3 and Table 2 ). Figure 3 : Level of knowledge among reproductive-age women attending ART clinic at Gamo zone government health institutions 2021 Table 2 Respondents Knowledge on Preconception care among HIV positive reproductive age women attending ART clinic in Gamo zone governmental health institutions 2021 Variables Frequency percent% Mention PCC components N = 286 =5 100 35.0 information on PCC n = 559 Yes 286 51.2 No 273 48.8 PCC service users N = 286 Only male 7 2.4 Female only 160 55.9 For both female & male 119 41.6 PCC is important N = 286 Yes 279 97.6 No 7 2.4 For whom PCC important N = 286 For baby, only 4 1.4 For mother, only 112 39.2 For all 170 59.4 Site for PCC service N = 286 At home 0 0.00 At health institution 256 89.5 At home and health institution 30 10.5 5.2.1 Respondents reason for not getting information on PCC ( Fig. 4 ) Figure 4 : Reason of respondents for not getting information about PCC amongwomen attending ART clinic at Gamo zone government health institutions 2021 Utilization of preconception care among respondents In general, as displayed in the below figure the result from the study showed that 178(32%) of reproductive age women utilized preconception care services. Among those HIV testing and counseling and ART 559 (100%), partner counseling and testing 134(24%), and 187(33.5%) had a discussion about preconception care with healthcare care providers.(Fig. 5 and Table 3 ) Figure 5 Overall utilization of preconception care among HIV positive reproductive Age group women attending ART clinic at Gamo Zone Government health institutions 2021 Table 3 Frequency distribution of utilization of preconception care components among HIV-positive women in Gamo zone government health institutions, 2021 Preconception care components Frequency Percent (%) HIV testing and counseling 559 100 Anti Retroviral therapy 559 100 partner counseling and testing 134 24 Pregnancy desire and viral load assessment 45 8.1 Nutrition counseling 71 12.7 ferrous supplementation 23 13.1 Immunization 45 4.1 family planning 143 25.6 counseling on alcohol and cigarette cessation 34 6.1 Other (STI screening and treatment). 9 1.6 Obstetrics characteristics of the participants Of the total 559 participants, 452 (80.9%) respondents had a pregnancy history and 393(86.9%) gave birth in the past. Among those majority of women 356 (78.6%) were multigravida and 261(57.7%) of women were multiparous. 59(13.1%) of the women experience abortion among those 44(75%) of them were spontaneous. 44(7.9%) of women are currently pregnant. Of those 35(79.5%) pregnancies are desired. Of the total respondents, 236(42.3%) are wanted a child for the future. More than half 249(44.5%) of women experienced pregnancy after they become HIV positive and 128(51.4%) of women develop problems through their pregnancy and delivery time (Fig. 6 ). Figure 6 : proportion of women who experience pregnancy and birth-related complications among HIV positive reproductive age group women attending ART clinic at Gamo Zone Government health institutions 2021 Facility related and other factors Of the total of 178 women who had preconception care, 178(100%) get the service from health institutions,among those 98(55.1%) and 107(60.1%) of women say they get laboratory services and medications respectively from health institutions. Among those 99(55.6%) of women encountered challenges during care, and the most frequently mentioned challenge was negligence from health care providers. however, all the participants mentioned that there is no unit for PCC service in health institutions. (Fig. 7 ) Figure 7 : problems encountered during utilization of preconception care among reproductive-age women attending ART clinic at Gamo zone Government health institutions2021 Factors associated with utilization of preconception care In bivariate analysis, from socio-demographic characteristics (age of the respondents, marital status, educational level of the respondents, occupation of respondents, education level and occupation of husband, family size, and household monthly income), from knowledge (women’s information on preconception care, knowledge of women about preconception care service), from the obstetrics characteristics (history of pregnancy, history abortion,history of birth, number of pregnancy, Desire of having child, Problem duringpregnancy and delivery time, Duration of living with HIV )were the candidate variables(variables which had a p-value of ≤ 0.25) for multivariable logistic regression. The educational level of the respondents, occupation of the respondent, monthly income, history of pregnancy, and Number of pregnancies were statistically significant factors in multivariable logistic regression (p < 0.05) The multivariable logistic regression revealed that, Women who able read and write only had 4.34,times(AOR: 4.34; 95%CI: 2.00, 9.66), primary education3.43timea, (AOR: .3.43; 95%CI: 1.58, 7.47), secondary education 2.38times(AOR: 2.38; 95%CI: 1.02, 5.55) and college and above 4.42times (AOR: 4.42; 95%CI: 1.48, 13.17).more likely utilize preconception care as compared with those of cannot able to read and write atthe educational level. Women whose monthly income 1001-2500ETB were 2.91 times (AOR: 2.91; 95% CI 1.61, 5.26) and greater or equal to 5001ETB 2.85 times (AOR: 2.85; 95% CI 1.41, 5.74) more utilize preconception care as compared to monthly income less than 1000ETB. Women who have private employees were 55% less likely to utilize preconception care than women having government employees (AOR: 0.45; 95% CI 0.21, 0.96). Women who have a history of pregnancy were 2.99 more likely to utilize preconception care than women having no history of pregnancy (AOR: 2.99; 95% CI 1.18, 7.71). Women who had 2-4history pregnancy were 2.59 times (AOR: 2.59; 95% CI 1.37, 4.93) and women who five and above history of pregnancy were 2.97times (AOR: 2.97; 95% CI 1.28, 6.91) more likely to utilize preconception care than one and no history of pregnancy. (Table 4 ) Table 4 Factors independently associated with utilization of preconception care among HIV positive reproductive-age women in Gamo Zone government health institutions, South Ethiopia, 2021 Variables Utilization COR (95%) CI Adjusted OR(95%)CI yes No Educational status of the respondent No, read and write 13 105 1 1 Only read and write 40 99 4.93(2.42,10.02) 4.34(2.00, 9.66) Primary education 49 86 4.60(2.34,9.04) 3.43(1.58,7.47) Secondary education 36 59 3.26(1.65,6.46) 2.38(1.02,5.55) Collage and above 32 40 10.1 ( 4.82,21.17) 4.42(1.48,13.17) Occupation of the respondent Government employ 45 37 1 1 Private employee 45 133 0.28(0.16,0.48) 0.45(0.21,0.96) Student 7 60 0.10(0.04,0.26) 0.542(0.14, 1.26) House wife 47 127 0.30(0.18,0.53) 1.45(0.21, 1.00) NG employee 34 24 1.16(0.59,2.30) 1.21(0.53,2.75) Monthly income in ETB =5001 52 46 7.14(4.14,12.30) 2.85(1.41,5.74) History of pregnancy Yes 169 283 6.50(3.20, 13.21) 2.99(1.18, 7.71) No 9 98 1 1 Number of pregnancy 1 18 78 1 1 2–4 29 44 4.94(3.09,7.89) 2.599(1.37,4.93) >=5 122 161 4.30(2.31,7.98) 2.97(1.28,6.91) DISCUSSION In this study, we have assessed utilization of preconception care and its associated factors among HIV-positive reproductive age women and the finding revealed that the overall utilization of preconception care was (32%). This figure was lower than the study conducted in Nepal (51.0%). This difference is may be due in the previous study there isbetter discussion it is 92%, 96%, and 45% of women have discussion with FP, HIV and OB/Gyns specialists about preconception care, but in this study,only 26.8%of respondents have a discussion with a health care provider, and also this is maybe due to the health care system of the country /poor health policy and guidelines for preconception care in Ethiopia. However, the finding of this study was higher than the study conducted in Mekele city north Ethiopia 18.2%, Hawassa 13.3%,AdetGojam 9.6%, and Debre Birhan13.4% ( 14 , 15 ),( 16 ), ( 17 ). This difference might be due to the study population difference. In this study, we assessed utilization of preconception care among HIV-positive reproductive age women attending ART clinics who have good health-seeking behavior as compared to previous community-based studies. According to the finding of this study Women’s able to read and write educational level was 4.43 times, primary education 3.43 times, secondary education 2.38 times, college and above was 4.42 times more utilized PCC service than women who was unable to read and write.The finding of this study is consistent with the study conducted in westshewa,DebreBirhan, Mekele city,Adet, Gojam,and South Ethiopia( 13 , 14 , 16 – 18 ).This might be because educated women simply accessed, read and understand the purpose and importance of PCC but uneducated women can be less exposed to information about Preconception care.The information gap might an able them to understand the purpose and importance of PCC. This may have inclined their utilization of PCC because of these women to utilize the PCC services; they must be informed about the existing services. Women whose monthly income 1001-2500ETB 2.91 times and monthly income greater or equal to 5001ETB 2.85 times more utilizes preconception care compare to monthly income less than 1000ETB. This analysis indicates that the likelihood of utilizing PCC was higher among women having a better monthly income. This finding was supported by a study conducted in DebreBirhan, West Shewa zone, Oromia regional state( 13 , 17 ).This difference might be better socio-economic status easily access the service by easily covering different payment. Women’s occupational status was also significantly associated with the utilization of preconception care. In this study, reproductive-age women who have private employees were 55% less likely to utilize preconception care than a government employees. This difference might be private employee workers workingmore hours and busy to get preconception care. Women who have a history of pregnancy were 2.99 more likely to utilize preconception care than women having no history of pregnancy. This difference might be having history pregnant women better exposure to different maternal and child health servicesas compared to those women no history of pregnancy. CONCLUSION AND RECOMMENDATION Conclusion Less than one-third of the ART clients utilize pre-conception care services. Determinants of preconception care were higher educational status, government employee, higher monthly income, history of pregnancy, and number of pregnancy Recommendations Based on the findings of the study the following recommendations are given for the concerned bodies. Health institutions should strengthen on educating the importance of preconception care for all clients. Especially focuson less educational status, low monthly income and low and no history of pregnancy mother. Additionally, health institution arranges unit for pre-conception care service. Nongovernmental organizations should support health institutions to increase preconception care utilization by availing appropriate logistics and building preconception care service room, Town, Zonal, and Regional Health Offices should give special attention to preconception care services like other maternal and child services Federal Ministry of Health , policy makers are advised to incorporate preconception counseling and care for HIV-infected women as a routine part of primary health care to improve the utilization of preconception care Researchers who interest in factors affecting PCC among ART should conduct a strong study design. Abbreviations AIDS, Acquired Immune Deficiency Virus; ANC, Antenatal Care; ART, Anti-Retroviral treatment; FP, Family planning; HCP, Health Care Provider; HIV, Human Immune Deficiency virus; IDSA, Infectious Disease Society of America; IUGR, Intra Uterine Growth Restriction; MOH, Ministry Of Health; MTCT, Mother-To-Child Transmission; PCC, Preconception Counseling and Care; PMTCT, Prevention of Mother –To-Child Transmission; PrEP, Pre-Exposure Prophylaxis; STIs, Sexually Transmitted Infections; WHO, World Health Organization. Declarations Ethical consideration Ethical clearance obtained from the ethical review committee of Arbaminch College of Health Sciences. All concerned bodies officially contacted through letters and permission obtained at all levels. Institutions included in this study asked permission using formal letters from the Arbaminch College of health science. Verbal informed consent was obtained from all respondents. Each study participant was informed about confidentiality or privacy throughout the whole process. The collected data was kept with firm confidentiality in a much secure place. Acknowledgments First of all, we would like to thank almighty God who helps and kept us in this position Secondly, we would like to express our deep sense of thanks to the Arbaminch College of Health Sciences Research and community service core process office for its readiness to provide financial support and opportunity to prepare this research Thirdly,our deepest gratitude goes to the data collector and respondents who participated in the research. Finally, we would like to like to express our sincere appreciation to colleagues as well as our friends for their contribution and encouragement during this study. Author Contribution : The author Melkamu Tulbake and Birknesh Mereta are equally contributed to the acquisition of the data, analysis, interpretation of the result, and drafting of the article, and the co-authors:- Eyasu Ware, and Tadele Damena are participated fully in revising the article, giving the direction for this research work, and agreed on the journal to which the article will be sent for publication. Consent for publication:- Not applied Clinical trial number: - Not applicable Data availability : Dataset may be made available from the corresponding author on reasonable request, subject to ethical approval and applicable institutional restrictions. Competing Interests : The authors declare no competing interest Funding : The authors declare no more funding References Organization, W. H. Preconception care to reduce maternal and childhood mortality and morbidity (World Health Organization, 2012). Organization, W. H. Preconception care: Maximizing the gains for maternal and child health, policy brief 2013. World Health Organization: Geneva, Switzerland. Olayinka, O. A., Achi, O. T., Amos, A. O. & Chiedu, E. M. Awareness and barriers to utilization of maternal health care services among reproductive women in Amassoma community, Bayelsa State. Int. J. Nurs. midwifery . 6 (1), 10–15 (2014). Somers, E. C. & Marder, W. Infertility–prevention and management. Rheumatic Disease Clin. 43 (2), 275–285 (2017). Goossens, J. Preconception health and care: perspectives from the reproductive-aged population in Flanders (Ghent University, 2018). Obstetricians & ACo Gynecologists. Gynecologic care for women with human immunodeficiency virus. ACOG Pract. Bull. ; 117 . (2010). Vanni, V. et al. Safety of fertility treatments in women with systemic autoimmune diseases (SADs). Exp. Opin. Drug Saf. 18 (9), 841–852 (2019). Aaron, E. Z. & Criniti, S. M. Preconception health care for HIV-infected women. Topics in HIV medicine: a publication of the International AIDS Society, USA. ;15(4):137 – 41. (2007). Hoyt, M. J., Storm, D. S., Aaron, E. & Anderson, J. Preconception and contraceptive care for women living with HIV. Infectious diseases in obstetrics and gynecology. ;2012. (2012). Hardy, E. & Cu-Uvin, S. Care of the HIV-infected pregnant woman in the developed world. Obstetric Med. 8 (1), 13–17 (2015). Burdge, D. R. et al. Canadian consensus guidelines for the care of HIV-positive pregnant women: putting recommendations into practice. Cmaj 168 (13), 1683–1688 (2003). Demisse, T. L. et al. Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia. Reproductive health . 16 (1), 96 (2019). Fekene, D. B., Woldeyes, B. S., Erena, M. M. & Demisse, G. A. Knowledge, uptake of preconception care and associated factors among reproductive age group women in West Shewa zone, Ethiopia, 2018. BMC women's health . 20 (1), 1–8 (2020). Asresu, T. T., Hailu, D., Girmay, B., Abrha, M. W. & Weldearegay, H. G. Mothers’ utilization and associated factors in preconception care in northern Ethiopia: a community based cross sectional study. BMC pregnancy childbirth . 19 (1), 347 (2019). Kassa, A. & Yohannes, Z. Women’s knowledge and associated factors on preconception care at Public Health Institution in Hawassa City, South Ethiopia. BMC Res. Notes . 11 (1), 841 (2018). Goshu, Y., Liyeh, T. & Simegn Ayele, A. Preconception Care Utilization and its Associated Factors among Pregnant Women in Adet, North-Western Ethiopia (Implication of Reproductive Health). J Women's Health Care. ;7(445):2167-0420.1000445. (2018). Demisse, T. L. et al. Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia. Reproductive health . 16 (1), 1–10 (2019). Habte, A., Dessu, S. & Haile, D. Determinants of practice of preconception care among women of reproductive age group in southern Ethiopia, 2020: content analysis. Reproductive Health . 18 (1), 1–14 (2021). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 11 May, 2026 Reviews received at journal 09 May, 2026 Reviewers agreed at journal 05 May, 2026 Reviewers agreed at journal 05 May, 2026 Reviewers invited by journal 05 May, 2026 Editor assigned by journal 05 May, 2026 Editor invited by journal 04 May, 2026 Submission checks completed at journal 30 Apr, 2026 First submitted to journal 30 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Tulbake","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYFAC5mYIzc7D+OADkGZjJ6iFEaxFgoGZh9lwBkgLMwla2IR5wNYS0KDb3ths8DPncJ3BYd5jzDa/tsnzMTMwfviYg1uL2ZmDzYm92w5LGBzmS3uc23fbsI2ZgVly5jY8Wm4kNh/gBWvhMTfO7bnNCNTCxsyLT8v9h80H/0K0mElb9ty2J6zlBmNzMi9MC8OP24mEtZxJbDaW3ZYuOfMwX7Jhb8Pt5DZmxmb8fjl++LDk223W/HzHew8++PHntu389uaDHz7i0YIKGNvAZAOx6kHgDymKR8EoGAWjYKQAAPHcUfigE6xVAAAAAElFTkSuQmCC","orcid":"","institution":"Wolaita Sodo University","correspondingAuthor":true,"prefix":"","firstName":"Melkamu","middleName":"","lastName":"Tulbake","suffix":""},{"id":637954719,"identity":"f3a293ea-d15b-476f-8c38-2e44deea9449","order_by":1,"name":"Birknesh Mereta","email":"","orcid":"","institution":"Arba Minch health science college","correspondingAuthor":false,"prefix":"","firstName":"Birknesh","middleName":"","lastName":"Mereta","suffix":""},{"id":637954720,"identity":"54db4003-b6df-4263-a06e-872e40a16355","order_by":2,"name":"Eyasu Ware","email":"","orcid":"","institution":"Arba Minch health scince college","correspondingAuthor":false,"prefix":"","firstName":"Eyasu","middleName":"","lastName":"Ware","suffix":""},{"id":637954721,"identity":"9e956fbe-9e09-4dc0-91f5-b8191f3494f9","order_by":3,"name":"Tadele Damena","email":"","orcid":"","institution":"Jinka univeresity","correspondingAuthor":false,"prefix":"","firstName":"Tadele","middleName":"","lastName":"Damena","suffix":""}],"badges":[],"createdAt":"2026-04-23 11:08:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9505909/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9505909/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109217178,"identity":"c0008c85-94a4-44c2-8033-6d62e0803cdf","added_by":"auto","created_at":"2026-05-13 18:09:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":34599,"visible":true,"origin":"","legend":"\u003cp\u003eConceptual framework for the study utilization of preconception care and associated factors among HIV positive reproductive age women in the art ART clinics\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/a59ac68f3ba99b5096167d46.png"},{"id":109222322,"identity":"2fd329b8-e1fc-429f-a2c0-6345e6ba8099","added_by":"auto","created_at":"2026-05-13 21:07:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":48002,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic presentation of the Sampling procedure for the study utilization of preconception care and associated factors among HIV positive reproductive-age women in Gamo zone\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/0366ac7a70250d1cb2e58b78.png"},{"id":109217179,"identity":"aeac53de-cc00-4c41-b6cf-afa28ba05104","added_by":"auto","created_at":"2026-05-13 18:09:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":33745,"visible":true,"origin":"","legend":"\u003cp\u003eLevel of knowledge among reproductive-age women attending ART clinic at Gamo zone government health institutions 2021\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/05a4661941ac2400d2df6a26.png"},{"id":109222270,"identity":"2b690467-e885-43a9-9811-360b924c8c6e","added_by":"auto","created_at":"2026-05-13 21:06:44","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":32860,"visible":true,"origin":"","legend":"\u003cp\u003eReason of respondents for not getting information about PCC among women attending ART clinic at Gamo zone government health institutions 2021\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/067bef45466b39f4c722b608.png"},{"id":109252456,"identity":"c2836c2d-7f30-40d1-9b33-64a91bdc9b40","added_by":"auto","created_at":"2026-05-14 09:26:40","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":37446,"visible":true,"origin":"","legend":"\u003cp\u003eOverall utilization of preconception care among HIV positive reproductive\u003c/p\u003e\n\u003cp\u003eAge group women attending ART clinic at Gamo Zone Government health institutions 2021\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/feb46b24f10fc9e99e2ffb5f.png"},{"id":109222323,"identity":"c06db4fa-b385-4b47-ab01-6f45967f7616","added_by":"auto","created_at":"2026-05-13 21:07:21","extension":"jpeg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":212912,"visible":true,"origin":"","legend":"\u003cp\u003eproportion of women who experience pregnancy and birth-related complications among HIV positive reproductive age group women attending ART clinic at Gamo Zone Government health institutions 2021\u003c/p\u003e","description":"","filename":"floatimage6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/b1ca5ad88f8d47e72282453f.jpeg"},{"id":109217182,"identity":"b156418b-7e74-4ced-9245-b0a6d2be0a9b","added_by":"auto","created_at":"2026-05-13 18:09:48","extension":"jpeg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":262918,"visible":true,"origin":"","legend":"\u003cp\u003eproblems encountered during utilization of preconception care among reproductive-age women attending ART clinic at Gamo zone Government health institutions2021\u003c/p\u003e","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/3a931526cc34ab3066ec2667.jpeg"},{"id":109295828,"identity":"3956f1fe-7aed-4da0-9796-699e44690e06","added_by":"auto","created_at":"2026-05-15 08:37:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":950826,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9505909/v1/9231656b-6b1d-46fa-9661-63ec0ce39faf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eUtilization of Preconception Care, and Associated Factors Among HIV Positive Reproductive Age Women Attending Art Clinics at Gamo Zone Government Health Institutions Southern Ethiopia, 2020\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003ePreconception care is the provision of biomedical, behavioral, and social health interventions to women and couples prior to conception with the goal of enhancing their health and lowering behaviors and environmental or individual factors that may lead to poor health outcomes for mothers and children (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSix months prior to conception, preconception care offers a chance to change harmful habits early on, which may have a long-term favorable impact on the mother's and the child's (future) health outcomes (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). A number of international groups and organizations representing health professionals and policymakers have recognized the significance of this aspect of modern health care. It pertains to care prior to pregnancy, whether it be the first pregnancy or in between subsequent pregnancies (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs part of standard primary care, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and other national organizations advise providing comprehensive family planning and preconception counseling and care to all women of childbearing age (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Preconception care and counseling must be included in primary care settings in order to avoid unwanted pregnancies, safeguard the health of the mother and fetus during pregnancy, stop HIV transmission during pregnancy, and lower the risk of HIV transmission to uninfected partners (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe World Health Organization recommends that the preconception care package address the following areas: tobacco use, genetic conditions, environmental health, infertility/subfertility, interpersonal violence, too-early, unwanted, and rapid successive pregnancies, sexually transmitted infections, human immune deficiency virus, mental health, and nutritional conditions (screening for anemia and diabetes, supplementing iron and folic acid, information, education, and counseling and monitoring nutritional status) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePreconception care for women living with HIV aims to prevent unwanted pregnancy, improve maternal and fetal outcomes during pregnancy, optimize maternal health prior to pregnancy, prevent HIV transmission during pregnancy, and prevent HIV transmission to an uninfected sexual partner when attempting to conceive (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003cp\u003ePreconception care is equally important for HIV-positive women and should be part of standard HIV medical care. This includes talking about safe sex to prevent STIs and unwanted pregnancy, risk factors for prenatal transmission, the effects of antiretroviral medications on hormonal contraception, the effects of medication on a fetus should pregnancy occur, and vaccination as needed (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eAll women of reproductive age who are known to be HIV positive should get preconception care and counseling. Maternal virology and immunologic status, the timing and selection of antiretroviral medication (which must consider the possibility of pregnancy), education about the risk of prenatal transmission, and intervention techniques must all be included in such counseling (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eResearch revealed that preconception care is somewhat more common in industrialized nations than in developing nations, such as Ethiopia, since its goals and objectives are not widely recognized and understood in low-income nations. Knowledge of preconception care, sociodemographic, economic, and obstetric considerations, family planning history, and service availability and accessibility all had an impact on preconception care (27, 28.30).\u003c/p\u003e \u003cp\u003ePreconception care has a greater contribution to have a healthy pregnancy, and it has better importance in those HIV-positive women. Thus this study will assess utilization of preconception care and associated factors among HIV-positive reproductive age group women. (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: Conceptual framework for the study utilization of preconception care and associated factors among HIV positive reproductive age women in the art ART clinics\u003c/p\u003e"},{"header":"METHODS AND MATERIALS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and period\u003c/h2\u003e \u003cp\u003eThe study was conducted in the Gamo zone of SNNPR. It has 14 woredas and one zonal town. The total population is 1,580,000 out of which 837,400 are females. Among this 368,140 (23.3%) females are under the reproductive age category. 3243 adults are on ART; among those 1728 are women of reproductive age. There are 4 primary hospitals and one general hospital, 57 health centers, 299 health posts, and also, private facilities are found in the zone. Three hospitals and ten health centers provide ART services in Gammo Zone.Arbaminch town is the zonal town of the Gamo zone which is located 505 km from Addis Ababa, the capital city of Ethiopia, and 227 Km from Hawasa the regional capital city of SNNPR. The study was conducted from March 1- April 1, 2021.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eA facility-based cross-sectional study was conducted.\u003c/p\u003e\n\u003ch3\u003ePopulation\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eSource population\u003c/strong\u003e \u003cp\u003eAll HIV-positive women of reproductive age group attending ART clinics in theGamo zone governmental health facilities\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy population\u003c/b\u003e: all selectedHIV-positive women of reproductive age attending ART clinics in theGamo zone government health facilities during the study period\u003c/p\u003e\n\u003ch3\u003eEligibility criteria\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eInclusion criteria\u003c/strong\u003e \u003cp\u003eHIV-positive women of reproductive age attending ART clinics in the public health institution during the study period without considering marital and pregnancy status\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eExclusion criteria\u003c/strong\u003e \u003cp\u003ecritically ill HIV-positive reproductive-age women who cannot communicate attending ART clinics in the selected public health institutions during the study period\u003c/p\u003e \u003c/p\u003e\n\u003ch3\u003eSAMPLE SIZE DETERMINATION\u003c/h3\u003e\n\u003cp\u003eThere is no study in a similar setting to this study. Thus we calculate for both objectives by the following assumption. For the first objective Single population proportion formula was used on the assumption of 50% prevalence (p) of preconception care among HIV-positive reproductive-age women. 95% confidence interval (Za), 5% marginal error (d), n\u0026thinsp;=\u0026thinsp;384;\u003c/p\u003e \u003cp\u003eFor second by using two populations proportion by the following assumptions: level of confidence of 95%, power\u0026thinsp;=\u0026thinsp;80%, the ratio of exposed to unexposed three. Percent of outcome among exposed 20 and percent among non-exposed 10%. By the assumptions, 138 exposed 413 unexposed, and 551calculated. Thus we select 551 to get an adequate sample size for both specific objectives and add nonresponse 5%( 28) 579.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSAMPLING PROCEDURE\u003c/h2\u003e \u003cp\u003eThere are three hospitals and ten health centers that provide ART services in the Gamo zone. There are a total of 1728 HIV-positive women of reproductive age attending ART clinicsof government health institutions within one month period. In the study, all three hospitals and four out of the health center are included by using simple random sampling. Then prepare lists of patients to have an appointment in the data collection period. After preparing an updated list of HIV-positive reproductive age women sample was allocated by the proportional allocation method for each hospital. Finally, eligible study participants were taken by a computer generating simple random sampling method (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e:Schematic presentation of the Sampling procedure for the study utilization of preconception care and associated factors among HIV positive reproductive-age women in Gamo zone\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSTUDY VARIABLES\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eDependent variables\u003c/h2\u003e \u003cp\u003eUtilization of preconception care\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eIndependent variables\u003c/h2\u003e \u003cp\u003e \u003cb\u003eKnowledge on preconception care\u003c/b\u003e- Information on preconception care and level of knowledge\u003c/p\u003e \u003cp\u003e \u003cb\u003eSocio-demographic factors Age\u003c/b\u003e, marital status, educational status of the mother, occupation, and educational status of the husband, occupation of husband, monthly income, and family size.\u003c/p\u003e \u003cp\u003e \u003cb\u003eObstetric factor\u003c/b\u003e Parity, gravidity, history of (abortion, stillbirth, congenital anomaly, and neonatal death), history of contraceptive use.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFacility related factors\u003c/b\u003e Availability of PCC service provision room, Availability of adequate laboratory service availability of adequate medication.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eOPERATIONAL DEFINITION\u003c/h2\u003e \u003cp\u003e \u003cb\u003ePreconception care\u003c/b\u003eAny interventions either advice or treatment, and lifestyle modification before being pregnant. (Preconception care components in this study are, HIV(male partner testing, promote the safer sexual practice, ART and planning a pregnancy and assess plasma viral load, family planning, STI screening and treatment, Nutrition, Ferrous supplementation, Immunization, Advice on cessation of alcohol, Advice on cessation of cigarette smoking)(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cb\u003eKnowledge on preconception\u003c/b\u003e care: is information by which an HIV-positive reproductive age woman has about preconception care (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eGood knowledge\u003c/strong\u003e \u003cp\u003eThose who have scored above or equal to the mean score of correct respond to preconception knowledge questions.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePoor knowledge\u003c/strong\u003e \u003cp\u003eThose who have scored less than the mean score of correct responses to preconception care knowledge questions.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eUtilization of preconception care\u003c/strong\u003e \u003cp\u003eif a woman receives any intervention either advice or treatment and lifestyle modification before being pregnant. The level of utilization of preconception care was measured using clients‟ responses about any intervention either advice or treatment and lifestyle modification regarding components of preconception care.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedures\u003c/h2\u003e \u003cp\u003eThe interviewer-administered questionnaire was used to collect the data; data was collected by 8 trained health care providers and three supervisors through face to face interview method using a pre-tested and structured questionnaire.\u003c/p\u003e \u003cp\u003eThe questionnaire contains five parts including socioeconomic and demographic characteristics, obstetrics factors, Knowledge related factors, utilization, and facility-related factors of PCC.\u003c/p\u003e \u003cp\u003eConfidentiality of information, respondent\u0026rsquo;s rights, informed consent, and technique of interview supported with communication and discussion every day with the supervisors and data collectors about the problem faced were made during the data collection process.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eData quality management/Assurance\u003c/h2\u003e \u003cp\u003eVarious activities were performed to assure the quality of data. The English version questionnaire would be translated into Amharic by a person knowing both of the languages. The principal investigator and supervisors were frequently supervising the data collection process by checking the completeness of the required type of data to correct faults if any on the site of data collection. Proper training was givento the interviewers and supervisors of the data collection procedures, proper categorization, and coding of the questionnaire.\u003c/p\u003e \u003cp\u003eThe quality of data was assured by properly designing and pre-testing the questionnaire, the questionnaire was pre-tested on (5% of total sample size) respondents in health institutions that had similar characteristics with the study population.\u003c/p\u003e \u003cp\u003eEvery day, all the completed questionnaires were reviewed and checked for completeness and relevance by the supervisors and every other day by the principal investigator, and all the necessary feedback was offered to data collectors the next morning before the actual procedure.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical Approval\u003c/strong\u003e \u003cp\u003e \u003cb\u003eand Informed Consent\u003c/b\u003e \u003c/p\u003e \u003c/p\u003e \u003cp\u003eAll methods were carried out in accordance with relevant guidelines and regulations. The study protocol was approved by Arba Minch health science college, Approval No. Amchs/01/20/7036. Informed consent was obtained from all participants prior to participation. Participation was voluntary, confidentiality was maintained, and participants could withdraw at any time without consequence.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eDATA PROCESSING AND ANALYSIS\u003c/h2\u003e \u003cp\u003eData were entered by using Epi data version 3.1 and exported to SPSS statistical software package version 25 for data cleaning and analysis.\u003c/p\u003e \u003cp\u003eDuring analysis the variables are defined, categorized, and recoded, then frequencies and percentage of the different variables were computed. The bivariate analysis was used primarily to check which variables had an association with the dependent variable individually and multivariable logistic regression was conducted to analyze factors that have an independent association with the utilization of preconception care. All variables were found to be associated with the main outcome variables with 95% CI in the bi-variate model i, e. P-Value\u0026thinsp;\u0026lt;\u0026thinsp;0.25 and other important variables from other Studies will be a candidate for the multivariable model analysis, and variables having an independent association with outcome variable at P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered as statistically significant.\u003c/p\u003e \u003c/div\u003e "},{"header":"RESULT","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eSocio-demographic characteristics of Respondents\u003c/h2\u003e \u003cp\u003eA total of 559 reproductive-age women participated in this study with a response rate of 97.90%. The age of the study participants ranged from 15to 48 years with a mean age of 32.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.439 SD and two hundred ninety-one (51.2%)of respondents were married. The mean monthly income was 3333.34 while 144(31.3%) studied participants earn less than 1000 ETB. Occupations of the respondents and the rest were also mentioned in the table below. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-Demographic Characteristics of Respondents for preconception care among reproductive-age women attending ART clinic at Gamo zone government health institution, South Ethiopia, 2021 \u003cb\u003e(N\u0026thinsp;=\u0026thinsp;559)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge in year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorce\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eEducational status of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno read write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRead-write only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eOccupation of respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNG Employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eEducational status of husband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo read write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRead-write only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eOccupation of husband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNG Employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily laborer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eTotal house hold Monthly income in ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;=1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1001\u0026ndash;2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2501\u0026ndash;5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5001\u0026ndash;10000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of respondents towards preconception care\u003c/h2\u003e \u003cp\u003eOf the total of 559 participants, 286 (51.2%) of women have information about preconception care before. Of those who have information; health professionals were the major source of information 222 (75.3%) followed by media 74 (25.1%), friends 45(15.2%), and from families 23(7.7%). Based on the PCC component questions response 123(43%) of women have good knowledge of PCC. (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e \u003cb\u003eand\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: Level of knowledge among reproductive-age women attending ART clinic at Gamo zone government health institutions 2021\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRespondents Knowledge on Preconception care among HIV positive reproductive age women attending ART clinic in Gamo zone governmental health institutions 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003epercent%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMention PCC components\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003einformation on PCC\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;559\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePCC service users\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnly male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFor both female \u0026amp; male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePCC is important\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFor whom PCC important\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFor baby, only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFor mother, only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFor all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSite for PCC service\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAt home\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAt health institution\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAt home and health institution\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003e \u003cb\u003e5.2.1 Respondents reason for not getting information on PCC (\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: Reason of respondents for not getting information about PCC amongwomen attending ART clinic at Gamo zone government health institutions 2021\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eUtilization of preconception care among respondents\u003c/h2\u003e \u003cp\u003eIn general, as displayed in the below figure the result from the study showed that 178(32%) of reproductive age women utilized preconception care services. Among those HIV testing and counseling and ART 559 (100%), partner counseling and testing 134(24%), and 187(33.5%) had a discussion about preconception care with healthcare care providers.(Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e \u003cb\u003eand\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003c/strong\u003e \u003cp\u003eOverall utilization of preconception care among HIV positive reproductive\u003c/p\u003e \u003c/p\u003e \u003cp\u003eAge group women attending ART clinic at Gamo Zone Government health institutions 2021\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency distribution of utilization of preconception care components among HIV-positive women in Gamo zone government health institutions, 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreconception care components\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV testing and counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e559\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti Retroviral therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e559\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epartner counseling and testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnancy desire and viral load assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNutrition counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eferrous supplementation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efamily planning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecounseling on alcohol and cigarette cessation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther (STI screening and treatment).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eObstetrics characteristics of the participants\u003c/h2\u003e \u003cp\u003eOf the total 559 participants, 452 (80.9%) respondents had a pregnancy history and 393(86.9%) gave birth in the past. Among those majority of women 356 (78.6%) were multigravida and 261(57.7%) of women were multiparous. 59(13.1%) of the women experience abortion among those 44(75%) of them were spontaneous. 44(7.9%) of women are currently pregnant. Of those 35(79.5%) pregnancies are desired. Of the total respondents, 236(42.3%) are wanted a child for the future. More than half 249(44.5%) of women experienced pregnancy after they become HIV positive and 128(51.4%) of women develop problems through their pregnancy and delivery time (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e: proportion of women who experience pregnancy and birth-related complications among HIV positive reproductive age group women attending ART clinic at Gamo Zone Government health institutions 2021\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eFacility related and other factors\u003c/h2\u003e \u003cp\u003eOf the total of 178 women who had preconception care, 178(100%) get the service from health institutions,among those 98(55.1%) and 107(60.1%) of women say they get laboratory services and medications respectively from health institutions.\u003c/p\u003e \u003cp\u003eAmong those 99(55.6%) of women encountered challenges during care, and the most frequently mentioned challenge was negligence from health care providers. however, all the participants mentioned that there is no unit for PCC service in health institutions. (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e: problems encountered during utilization of preconception care among reproductive-age women attending ART clinic at Gamo zone Government health institutions2021\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eFactors associated with utilization of preconception care\u003c/h2\u003e \u003cp\u003eIn bivariate analysis, from socio-demographic characteristics (age of the respondents, marital status, educational level of the respondents, occupation of respondents, education level and occupation of husband, family size, and household monthly income), from knowledge (women\u0026rsquo;s information on preconception care, knowledge of women about preconception care service), from the obstetrics characteristics (history of pregnancy, history abortion,history of birth, number of pregnancy, Desire of having child, Problem duringpregnancy and delivery time, Duration of living with HIV )were the candidate variables(variables which had a p-value of \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026le;\u003c/span\u003e\u0026thinsp;0.25) for multivariable logistic regression. The educational level of the respondents, occupation of the respondent, monthly income, history of pregnancy, and Number of pregnancies were statistically significant factors in multivariable logistic regression (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003cp\u003eThe multivariable logistic regression revealed that, Women who able read and write only had 4.34,times(AOR: 4.34; 95%CI: 2.00, 9.66), primary education3.43timea, (AOR: .3.43; 95%CI: 1.58, 7.47), secondary education 2.38times(AOR: 2.38; 95%CI: 1.02, 5.55) and college and above 4.42times (AOR: 4.42; 95%CI: 1.48, 13.17).more likely utilize preconception care as compared with those of cannot able to read and write atthe educational level.\u003c/p\u003e \u003cp\u003eWomen whose monthly income 1001-2500ETB were 2.91 times (AOR: 2.91; 95% CI 1.61, 5.26) and greater or equal to 5001ETB 2.85 times (AOR: 2.85; 95% CI 1.41, 5.74) more utilize preconception care as compared to monthly income less than 1000ETB. Women who have private employees were 55% less likely to utilize preconception care than women having government employees (AOR: 0.45; 95% CI 0.21, 0.96). Women who have a history of pregnancy were 2.99 more likely to utilize preconception care than women having no history of pregnancy (AOR: 2.99; 95% CI 1.18, 7.71).\u003c/p\u003e \u003cp\u003eWomen who had 2-4history pregnancy were 2.59 times (AOR: 2.59; 95% CI 1.37, 4.93) and women who five and above history of pregnancy were 2.97times (AOR: 2.97; 95% CI 1.28, 6.91) more likely to utilize preconception care than one and no history of pregnancy. (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors independently associated with utilization of preconception care among HIV positive reproductive-age women in Gamo Zone government health institutions, South Ethiopia, 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eUtilization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95%) CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdjusted\u003c/p\u003e \u003cp\u003eOR(95%)CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eEducational status of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnly read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.93(2.42,10.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e4.34(2.00, 9.66)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.60(2.34,9.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.43(1.58,7.47)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.26(1.65,6.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.38(1.02,5.55)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollage and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.1 ( 4.82,21.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e4.42(1.48,13.17)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eOccupation of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28(0.16,0.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.45(0.21,0.96)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.10(0.04,0.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.542(0.14, 1.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30(0.18,0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.45(0.21, 1.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNG employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.16(0.59,2.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.21(0.53,2.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly income in ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;=1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1001\u0026ndash;2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.21,(3.09, 8.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.913(1.61,5.26)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2501\u0026ndash;5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.79(2.22,6.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.76(0.92, 3.41)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=5001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.14(4.14,12.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.85(1.41,5.74)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.50(3.20, 13.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.99(1.18, 7.71)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNumber of pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.94(3.09,7.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.599(1.37,4.93)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.30(2.31,7.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.97(1.28,6.91)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study, we have assessed utilization of preconception care and its associated factors among HIV-positive reproductive age women and the finding revealed that the overall utilization of preconception care was (32%). This figure was lower than the study conducted in Nepal (51.0%). This difference is may be due in the previous study there isbetter discussion it is 92%, 96%, and 45% of women have discussion with FP, HIV and OB/Gyns specialists about preconception care, but in this study,only 26.8%of respondents have a discussion with a health care provider, and also this is maybe due to the health care system of the country /poor health policy and guidelines for preconception care in Ethiopia.\u003c/p\u003e \u003cp\u003eHowever, the finding of this study was higher than the study conducted in Mekele city north Ethiopia 18.2%, Hawassa 13.3%,AdetGojam 9.6%, and Debre Birhan13.4% (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e),(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). This difference might be due to the study population difference. In this study, we assessed utilization of preconception care among HIV-positive reproductive age women attending ART clinics who have good health-seeking behavior as compared to previous community-based studies.\u003c/p\u003e \u003cp\u003eAccording to the finding of this study Women\u0026rsquo;s able to read and write educational level was 4.43 times, primary education 3.43 times, secondary education 2.38 times, college and above was 4.42 times more utilized PCC service than women who was unable to read and write.The finding of this study is consistent with the study conducted in westshewa,DebreBirhan, Mekele city,Adet, Gojam,and South Ethiopia(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).This might be because educated women simply accessed, read and understand the purpose and importance of PCC but uneducated women can be less exposed to information about Preconception care.The information gap might an able them to understand the purpose and importance of PCC. This may have inclined their utilization of PCC because of these women to utilize the PCC services; they must be informed about the existing services.\u003c/p\u003e \u003cp\u003eWomen whose monthly income 1001-2500ETB 2.91 times and monthly income greater or equal to 5001ETB 2.85 times more utilizes preconception care compare to monthly income less than 1000ETB. This analysis indicates that the likelihood of utilizing PCC was higher among women having a better monthly income. This finding was supported by a study conducted in DebreBirhan, West Shewa zone, Oromia regional state(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).This difference might be better socio-economic status easily access the service by easily covering different payment.\u003c/p\u003e \u003cp\u003eWomen\u0026rsquo;s occupational status was also significantly associated with the utilization of preconception care. In this study, reproductive-age women who have private employees were 55% less likely to utilize preconception care than a government employees. This difference might be private employee workers workingmore hours and busy to get preconception care.\u003c/p\u003e \u003cp\u003eWomen who have a history of pregnancy were 2.99 more likely to utilize preconception care than women having no history of pregnancy. This difference might be having history pregnant women better exposure to different maternal and child health servicesas compared to those women no history of pregnancy.\u003c/p\u003e "},{"header":"CONCLUSION AND RECOMMENDATION","content":"\n\u003ch3\u003eConclusion\u003c/h3\u003e\n\u003cp\u003eLess than one-third of the ART clients utilize pre-conception care services. Determinants of preconception care were higher educational status, government employee, higher monthly income, history of pregnancy, and number of pregnancy\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003eBased on the findings of the study the following recommendations are given for the concerned bodies.\u003c/p\u003e \u003cp\u003e \u003cb\u003eHealth institutions\u003c/b\u003e should strengthen on educating the importance of preconception care for all clients. Especially focuson less educational status, low monthly income and low and no history of pregnancy mother. Additionally, health institution arranges unit for pre-conception care service.\u003c/p\u003e \u003cp\u003e \u003cb\u003eNongovernmental organizations\u003c/b\u003e should support health institutions to increase preconception care utilization by availing appropriate logistics and building preconception care service room, \u003cb\u003eTown, Zonal, and Regional Health Offices\u003c/b\u003e should give special attention to preconception care services like other maternal and child services\u003c/p\u003e \u003cp\u003e \u003cb\u003eFederal Ministry of Health\u003c/b\u003e, policy makers are advised to incorporate preconception counseling and care for HIV-infected women as a routine part of primary health care to improve the utilization of preconception care\u003c/p\u003e \u003cp\u003e \u003cb\u003eResearchers\u003c/b\u003e who interest in factors affecting PCC among ART should conduct a strong study design.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAIDS, Acquired Immune Deficiency Virus; ANC, Antenatal Care; ART, Anti-Retroviral treatment; FP, Family planning; HCP, Health Care Provider; HIV, Human Immune Deficiency virus; IDSA, Infectious Disease Society of America; IUGR, Intra Uterine Growth Restriction; MOH, Ministry Of Health; MTCT, Mother-To-Child Transmission; PCC, Preconception Counseling and Care; PMTCT, Prevention of Mother \u0026ndash;To-Child Transmission; PrEP, Pre-Exposure Prophylaxis; STIs, Sexually Transmitted Infections; WHO, World Health Organization.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance obtained from the ethical review committee of Arbaminch College of Health Sciences. All concerned bodies officially contacted through letters and permission obtained at all levels. Institutions included in this study asked permission using formal letters from the Arbaminch College of health science.\u003c/p\u003e\n\u003cp\u003eVerbal informed consent was obtained from all respondents. Each study participant was informed about confidentiality or privacy throughout the whole process. The collected data was kept with firm confidentiality in a much secure place.\u003c/p\u003e\n\u003cp id=\"_Toc21903\"\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst of all, we would like to thank almighty God who helps and kept us in this position\u003c/p\u003e\n\u003cp\u003eSecondly, we would like to express our deep sense of thanks to the Arbaminch College of Health Sciences Research and community service core process office for its readiness to provide financial support and opportunity to prepare this research\u003c/p\u003e\n\u003cp\u003eThirdly,our deepest gratitude goes to the data collector and respondents who participated in the research.\u003c/p\u003e\n\u003cp\u003eFinally, we would like to like to express our sincere appreciation to colleagues as well as our friends for their contribution and encouragement during this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author Melkamu Tulbake\u0026nbsp;and Birknesh Mereta\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eare equally contributed to the acquisition of the data, analysis, interpretation of the result, and drafting of the article, and the co-authors:-\u0026nbsp;Eyasu Ware, and Tadele Damena are participated fully in revising the article, giving the direction for this research work, and agreed on the journal to which the article will be sent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:-\u003c/strong\u003eNot applied\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number: -\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDataset may be made available from the corresponding author on reasonable request, subject to ethical approval and applicable institutional restrictions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eThe authors declare no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eThe authors declare no more funding\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrganization, W. H. \u003cem\u003ePreconception care to reduce maternal and childhood mortality and morbidity\u003c/em\u003e (World Health Organization, 2012).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization, W. H. Preconception care: Maximizing the gains for maternal and child health, policy brief 2013. World Health Organization: Geneva, Switzerland.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlayinka, O. A., Achi, O. T., Amos, A. O. \u0026amp; Chiedu, E. M. Awareness and barriers to utilization of maternal health care services among reproductive women in Amassoma community, Bayelsa State. \u003cem\u003eInt. J. Nurs. midwifery\u003c/em\u003e. \u003cb\u003e6\u003c/b\u003e (1), 10\u0026ndash;15 (2014).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSomers, E. C. \u0026amp; Marder, W. Infertility\u0026ndash;prevention and management. \u003cem\u003eRheumatic Disease Clin.\u003c/em\u003e \u003cb\u003e43\u003c/b\u003e (2), 275\u0026ndash;285 (2017).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoossens, J. \u003cem\u003ePreconception health and care: perspectives from the reproductive-aged population in Flanders\u003c/em\u003e (Ghent University, 2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eObstetricians \u0026amp; ACo Gynecologists. Gynecologic care for women with human immunodeficiency virus. \u003cem\u003eACOG Pract. Bull.\u003c/em\u003e ;\u003cb\u003e117\u003c/b\u003e. (2010).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVanni, V. et al. Safety of fertility treatments in women with systemic autoimmune diseases (SADs). \u003cem\u003eExp. Opin. Drug Saf.\u003c/em\u003e \u003cb\u003e18\u003c/b\u003e (9), 841\u0026ndash;852 (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAaron, E. Z. \u0026amp; Criniti, S. M. Preconception health care for HIV-infected women. Topics in HIV medicine: a publication of the International AIDS Society, USA. ;15(4):137\u0026thinsp;\u0026ndash;\u0026thinsp;41. (2007).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoyt, M. J., Storm, D. S., Aaron, E. \u0026amp; Anderson, J. Preconception and contraceptive care for women living with HIV. Infectious diseases in obstetrics and gynecology. ;2012. (2012).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHardy, E. \u0026amp; Cu-Uvin, S. Care of the HIV-infected pregnant woman in the developed world. \u003cem\u003eObstetric Med.\u003c/em\u003e \u003cb\u003e8\u003c/b\u003e (1), 13\u0026ndash;17 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurdge, D. R. et al. Canadian consensus guidelines for the care of HIV-positive pregnant women: putting recommendations into practice. \u003cem\u003eCmaj\u003c/em\u003e \u003cb\u003e168\u003c/b\u003e (13), 1683\u0026ndash;1688 (2003).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemisse, T. L. et al. Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia. \u003cem\u003eReproductive health\u003c/em\u003e. \u003cb\u003e16\u003c/b\u003e (1), 96 (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFekene, D. B., Woldeyes, B. S., Erena, M. M. \u0026amp; Demisse, G. A. Knowledge, uptake of preconception care and associated factors among reproductive age group women in West Shewa zone, Ethiopia, 2018. \u003cem\u003eBMC women's health\u003c/em\u003e. \u003cb\u003e20\u003c/b\u003e (1), 1\u0026ndash;8 (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsresu, T. T., Hailu, D., Girmay, B., Abrha, M. W. \u0026amp; Weldearegay, H. G. Mothers\u0026rsquo; utilization and associated factors in preconception care in northern Ethiopia: a community based cross sectional study. \u003cem\u003eBMC pregnancy childbirth\u003c/em\u003e. \u003cb\u003e19\u003c/b\u003e (1), 347 (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKassa, A. \u0026amp; Yohannes, Z. Women\u0026rsquo;s knowledge and associated factors on preconception care at Public Health Institution in Hawassa City, South Ethiopia. \u003cem\u003eBMC Res. Notes\u003c/em\u003e. \u003cb\u003e11\u003c/b\u003e (1), 841 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoshu, Y., Liyeh, T. \u0026amp; Simegn Ayele, A. Preconception Care Utilization and its Associated Factors among Pregnant Women in Adet, North-Western Ethiopia (Implication of Reproductive Health). J Women's Health Care. ;7(445):2167-0420.1000445. (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemisse, T. L. et al. Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia. \u003cem\u003eReproductive health\u003c/em\u003e. \u003cb\u003e16\u003c/b\u003e (1), 1\u0026ndash;10 (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHabte, A., Dessu, S. \u0026amp; Haile, D. Determinants of practice of preconception care among women of reproductive age group in southern Ethiopia, 2020: content analysis. \u003cem\u003eReproductive Health\u003c/em\u003e. \u003cb\u003e18\u003c/b\u003e (1), 1\u0026ndash;14 (2021).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Preconception care, utilization, human immune deficiency virus, Gamo zone","lastPublishedDoi":"10.21203/rs.3.rs-9505909/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9505909/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003ePreconception care is specialized care targeted at women of reproductive age before and between pregnancies to increase the chance of having a healthy baby and being a healthy mother. The prevalence of preconception care in HIV-positive women was low which increase the vertical transmission of the Human Immune Deficiency Virus and adverse birth outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e፡ To assess utilization of preconception care and associated factors among Human Immune Deficiency Virus positive reproductive age women attending Anti-Retroviral Treatment clinics in Gamo zone 2020/2021\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod: \u003c/strong\u003eInstitution-based cross-sectional study was conducted fromMarch20-May132021. 559 study participants were selected by simple random sampling technique. Data were collected using Structured, pre-tested, interviewer-administered questionnaires, then coded and entered into Epi data 3.1 and exported to SPSS version 25 for cleaning and analysis. In bivariate analysisvariables with a P-value \u0026lt; 0.25 were transferred to multivariate analysisand a P-value of \u0026lt; 0.05 with 95%, CI is considered for the presence of a statistically significant association.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult: \u003c/strong\u003eA total of 559 HIV-positive women participated with a response rate of 97.9% .over all utilization of preconception care was32%. Education, Monthly income,History of pregnancy, Number of pregnancyand Occupation were significantly associated with utilization of preconception care with (AOR: 4.42; 95%CI: 1.48, 13.17), (AOR: 2.85; 95% CI 1.41, 5.74), (AOR: 2.99; 95% CI 1.18, 7.71), (AOR: 2.97; 95% CI 1.28, 6.91), and(AOR: 0.45; 95% CI 0.21, 0.96) respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: prevalence of preconception care among HIV-positive women was law. Educational status, occupation, monthly income, history of pregnancy, and several pregnancies were factors associated with utilization of preconception care. All stakeholders should work together to address the identified problems.\u003c/p\u003e","manuscriptTitle":"Utilization of Preconception Care, and Associated Factors Among HIV Positive Reproductive Age Women Attending Art Clinics at Gamo Zone Government Health Institutions Southern Ethiopia, 2020","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-13 18:09:44","doi":"10.21203/rs.3.rs-9505909/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"320255434250639530275637086373870438803","date":"2026-05-11T06:15:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T02:51:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"30392889831009978797290718075339260230","date":"2026-05-06T03:40:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"247576204747720617845174791928548702274","date":"2026-05-05T13:58:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-05T13:32:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-05T13:28:22+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-05-04T11:44:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-30T09:25:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-04-30T08:15:17+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aa475e13-cda9-46d4-8ae4-5b472e9065be","owner":[],"postedDate":"May 13th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"320255434250639530275637086373870438803","date":"2026-05-11T06:15:43+00:00","index":55,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T02:51:24+00:00","index":53,"fulltext":""},{"type":"reviewerAgreed","content":"30392889831009978797290718075339260230","date":"2026-05-06T03:40:48+00:00","index":50,"fulltext":""},{"type":"reviewerAgreed","content":"247576204747720617845174791928548702274","date":"2026-05-05T13:58:32+00:00","index":46,"fulltext":""},{"type":"reviewersInvited","content":"19","date":"2026-05-05T13:32:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-05T13:28:22+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-05-04T11:44:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-30T09:25:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-04-30T08:15:17+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":68108922,"name":"Health sciences/Diseases"},{"id":68108923,"name":"Health sciences/Health care"},{"id":68108924,"name":"Health sciences/Medical research"},{"id":68108925,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-05-13T18:09:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-13 18:09:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9505909","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9505909","identity":"rs-9505909","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}