Introduction: despite increasing efforts to address the reproductive health needs of persons living with Human Immuno-Deficiency Virus (HIV), a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. Currently, Ethiopia promotes integration of family planning (FP) services in to HIV chronic care. Yet the contraceptive prevalence rate among clients remains low. The objective of the study was to assess the role of socio-cultural factors on modern family planning use among HIV+ clients attending Anti-Retroviral Therapy clinics in Addis Ababa sub-cities.

Methods: the study involved a facility based cross sectional survey. The ten sub cities were initially categorized/stratified into 5 based on direction (East, West, South, North and Central) and from each category one sub city was randomly selected. The total sample size was proportionally allocated to the selected health facilities according to previous monthly average client load per health center. Participants were selected using simple random sampling technique during their routine visit at the health centers. Data were collected through a semi-structured interviewer administered questionnaire. Both descriptive and inferential statistics were generated and results considered significant at 95% confidence level using STATA version 14.0.

Results: six hundred and thirty-six clients participated in the study. Majority of them were age between 30-39 years. Though majority, 607 (95.4%) participants approved the use of modern FP method, current use rate stood at 39%. Condom was the most (14.5%) commonly used single method. The odds of FP use by participants who disclosed their HIV status were almost twice that of their counterparts (AOR= 1.84; 95% CI: 1.14, 2.95). Participants who held discussion with their spouse/partners concerning FP, irrespective of the frequency had an odd of more than four when using FP than their counterparts (AO= 4.35; 95% CI: 2.69, 7.04).

Conclusion: this study revealed that 6 out of every 10 HIV+ clients are not currently using FP methods. Disclosure of HIV status as well as open discussion with spouse/partner were positively associated with family planning use. These study findings call for comprehensive and client focus FP education and counseling in line with disclosure of HIV status and dialogue with spouse/partner in order to increase uptake and utilization of FP among clients. Partners have a great influence on the use and choice of FP methods, so their views are paramount.