Contraceptive Use and Counseling Preferences Among Human Immunodeficiency Virus–Positive Women

Abstract

INTRODUCTION: The objective is to describe contraceptive use and preferred mode of contraceptive service provision among women with human immunodeficiency virus (HIV) to identify factors that could improve effective contraceptive use. METHODS: This was a cross-sectional study of 80 HIV-positive women, 18–45 years old, at an academic center and a health department. We assessed contraceptive use and preferences for contraceptive services using interviewer-administered questionnaires. Exclusion criteria included sterilization, hysterectomy, history of infertility, postmenopausal, or planning pregnancy in the next 6 months. We used multivariate regression analysis to calculate adjusted relative risks of using effective contraception based on counseling context. RESULTS: Thirty percent of the women surveyed were using effective contraception (Table 1); injectables were most common (33%) followed by combined contraceptive pills (29%), intrauterine contraception (21%), and implant (17%). The majority of participants' (68%) only health care provider was their HIV specialist. Forty-nine percent of women preferred having contraceptive counseling provided by an HIV specialist and 16% preferred a gynecologist. Forty-four percent preferred to receive contraceptive counseling in the HIV clinic and 12.5% preferred the gynecology clinic. Having a gynecologist was not significantly associated with using effective contraception (adjusted relative risk 1.4, 95% confidence interval [CI] 0.7–2.8). Discussing contraception with an HIV provider was associated with use of effective contraception (adjusted relative risk 2.8, 95% CI 1.2–7.1).CONCLUSION: HIV-positive women report a preference for receiving contraceptive counseling in the HIV care setting and they are more likely to use effective contraception when discussed with their HIV provider.