Trends in Contraception Use and Contraception Method Preference at Last Intercourse in Cisgender Women at High Risk for HIV Acquisition [ID: 1373337

Abstract

INTRODUCTION: Cisgender women account for almost 20% of new human immunodeficiency virus (HIV) infections in the United States. This study aims to assess contraception use at last intercourse in cisgender women at high risk for HIV acquisition. METHODS: We abstracted demographics, socioeconomic status, HIV risk, and reproductive health information from the 2017 iteration of the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System. We used survey-weighted logistic regression adjusted for several demographic factors to compare trends of contraception use between those at low and high risk for HIV acquisition, which was defined as those who have engaged in transactional sex practices, used injection drugs, or been treated for a sexually transmitted infection in the past year. RESULTS: Women at high risk for HIV acquisition had no significant difference in contraception use at last intercourse compared to those at low risk (P=.262, odds ratio [OR] 1.11 [0.93–1.32]). Among those who did not use contraception at last intercourse, women at risk for HIV acquisition were more likely to state indifference toward getting pregnant (P=.029, OR 1.79 [1.06–3.01]) and lapse in method use (P=.001, OR 4.55 [1.80–11.5]) as reasons for not using contraception. Additionally, those at high risk for HIV were more likely to have had an intrauterine device (IUD) (unknown type) at last intercourse (P<.001, OR 1.70 [1.28–2.24]) and less likely to have used hormonal shots (P=.015, OR 0.47 [0.26–0.86]). CONCLUSION: Women at risk for HIV are more likely to have had an IUD at last intercourse, which could indicate a role for the integration of HIV preexposure prophylaxis and family planning. Contraception method preference in this population and attitudes toward pregnancy should be further investigated.