Knowledge, Attitude, Practice and Barriers Regarding Safe Sex and Contraceptive Use in Rural Women in Fiji

Abstract

<p><strong>Background:</strong> Fiji has a low contraceptive uptake rate and high rates of unplanned pregnancy and sexually transmitted infections (STIs).  In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to safe sex and contraceptive use, conducted on 1494 rural women aged between 18 to 75 years in Fiji.</p><p><strong>Objectives:</strong> To explore the knowledge, attitudes, practice and barriers regarding safe sex and contraceptive use in rural women of Ba, Lautoka and Nadi, in Fiji.</p><p><strong>Methods:</strong> Structured questionnaires were administered to women presenting to rural outreach Sexual and Reproductive Health (SRH) education sessions and clinics conducted by trained health educators and clinicians.</p><p><strong>Results: </strong>Knowledge on how pregnancy occurred and how to avoid pregnancies was high<strong> </strong>(86% and 83% respectively); but when it came to practice 43% of women had never used a contraceptive. Despite 81% of women having completed either secondary or tertiary education, 88% were not aware of emergency contraception. Fifty three percent of respondents were unaware that condom use provided protection against both pregnancy and STIs. Sixty three percent knew how an STI is contracted but 48% were unaware of any of the symptoms of STIs. Women offered ‘lack of knowledge’ (53%), ‘being married’ (17%), ‘difficulty accessing’ (10%) or ‘partner disagrees’ (7%) as the common barriers to condom use. Forty percent of women were unable to articulate a barrier to contraceptive use and said they did not know whereas 21% said ‘fear’, 15% said ‘partner objecting’ and 5% said ‘religion’ were barriers.</p><p><strong>Conclusion: </strong>While a high percentage of women had some knowledge of how to avoid pregnancies and how STIs were contracted, this did not translate to practice of safe sex or use of contraceptives.<strong> </strong>Review of current education and health programs is necessary to ensure that misinformation and false perceptions do not act as barriers. The influence of the partner needs further research.<strong></strong></p>