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Abstract
Results Couple baseline serostatus and contraception usage were both individual effect measure modifiers (p<0.0001). Among couples in which the woman was not using a contraceptive method at baseline (N=782), there was no significant effect of the interventions overall or when stratifying by couple serostatus on incident pregnancy. Among couples in which the woman was using a contraceptive method at baseline, concordant positive couples (HR = 0.20; 95%CI: 0.08-0.53), and couples in which the woman was HIV positive at baseline (HR = 0.21; 95%CI: 0.09-0.51) who received “Methods + Both” interventions which combined information on contraceptive methods and motivational messages for future planning behaviors were at significantly decreased hazard for pregnancy relative to those receiving “Motivational + Control” interventions – which provided motivational messages for future planning but not information on contraceptive methods.
Highlights
Prevention of unintended pregnancy, especially among HIV positive couples and in settings where both HIV and total fertility rates are high, is a critical public health initiative
A factorial randomized controlled trial evaluated the effect on incident pregnancy of two interventions (a “Methods” and “Motivational” intervention) to promote long-term contraceptive use among HIV serodiscordant and concordant positive couples (N = 1060) identified from CVCT clinics in Lusaka, Zambia
Among couples in which the woman was not using a contraceptive method at baseline (N=782), there was no significant effect of the interventions overall or when stratifying by couple serostatus on incident pregnancy
Summary
Effect of an intervention to promote contraceptive uptake on incident pregnancy: a randomized controlled trial among HIV positive couples in Zambia. K Wall1*, B Vwalika, L Haddad, N Htee Khu, C Vwalika, W Kilembe, E Chomba, R Stephenson, D Kleinbaum, A Nizam, I Brill, A Tichacek, S Allen
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