High Uptake of Postpartum Hormonal Contraception Among HIV-1-Seropositive Women in Kenya

Balkus, Jennifer E.; Bosire, Rose; John‐Stewart, Grace; Mbori‐Ngacha, Dorothy; Schiff, Melissa A.; Wamalwa, Dalton; Gichuhi, Christine; Obimbo, Elizabeth; Wariua, Grace; Farquhar, Carey

doi:10.1097/01.olq.0000218880.88179.36

Cited by 27 publications

(32 citation statements)

References 13 publications

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“…In particular, and in contrast with our hypothesis, women receiving HAART were significantly more likely to report contraceptive use while HIV-positive HAART-naïve women were non-significantly more likely to use contraception compared with HIV-negative women. Overall, over 80% of HIV-positive women in our study reported contraceptive use, which falls within the upper range reported for HIV-positive women elsewhere in sub-Saharan Africa (46%–85%) [16], [17], [25], [32], [42], [43]. Contraceptive prevalence among HIV-negative women in our study was 69%, which is highly comparable to estimates among women in the general South African population [41].…”

Section: Discussionsupporting

confidence: 79%

Contraceptive Use and Method Preference among Women in Soweto, South Africa: The Influence of Expanding Access to HIV Care and Treatment Services

et al. 2010

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ObjectivePreventing unintended pregnancy among HIV-positive women constitutes a critical and cost-effective approach to primary prevention of mother-to-child transmission of HIV and is a global public health priority for addressing the desperate state of maternal and child health in HIV hyper-endemic settings. We sought to investigate whether the prevalence of contraceptive use and method preferences varied by HIV status and receipt of highly active antiretroviral therapy (HAART) among women in Soweto, South Africa.MethodsWe used survey data from 563 sexually active, non-pregnant women (18–44 years) recruited from the Perinatal HIV Research Unit in Soweto (May–December, 2007); 171 women were HIV-positive and receiving HAART (median duration of use = 31 months; IQR = 28, 33), 178 were HIV-positive and HAART-naïve, and 214 were HIV-negative. Medical record review was conducted to confirm HIV status and clinical variables. Logistic regression models estimated adjusted associations between HIV status, receipt of HAART, and contraceptive use.ResultsOverall, 78% of women reported using contraception, with significant variation by HIV status: 86% of HAART users, 82% of HAART-naïve women, and 69% of HIV-negative women (p<0.0001). In adjusted models, compared with HIV-negative women, women receiving HAART were significantly more likely to use contraception while HAART-naïve women were non-significantly more likely (AOR: 2.40; 95% CI: 1.25, 4.62 and AOR: 1.59; 95% CI: 0.88, 2.85; respectively). Among HIV-positive women, HAART users were non-significantly more likely to use contraception compared with HAART-naïve women (AOR: 1.55; 95% CI: 0.84, 2.88). Similar patterns held for specific use of barrier (primarily male condoms), permanent, and dual protection contraceptive methods.ConclusionAmong HIV-positive women receiving HAART, the observed higher prevalence of contraceptive use overall and condoms in particular promises to yield fewer unintended pregnancies and reduced risks of vertical and sexual HIV transmission. These findings highlight the potential of integrated HIV and reproductive health services to positively impact maternal, partner, and child health.

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Section: Discussionsupporting

confidence: 79%

Contraceptive Use and Method Preference among Women in Soweto, South Africa: The Influence of Expanding Access to HIV Care and Treatment Services

et al. 2010

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“…Taking HIV prevention a step further to include access to effective family planning services for women living with HIV who want to avoid an unplanned pregnancy [37] can prevent more paediatric HIV infections than is promised by the current low coverage of prevention of mother-tochild transmission programmes.…”

Section: Gender and Hiv Preventionmentioning

confidence: 99%

Gender, sex, and HIV: how well are we addressing the imbalance?

Hankins¹

2008

Current Opinion in HIV and AIDS

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“…75 More research is needed regarding access to and use of contraceptive methods among HIV positive women and men, in order for services to be better able to tailor service delivery to them. 76 …”

Section: Service Delivery Implicationsmentioning

confidence: 99%

“…The small proportion of women who develop heavy bleeding with either method need to be treated promptly to avoid serious consequences. 76,89 Research is needed on interactions between medical abortion drugs and antiretroviral therapies, as evidence is scarce. Improvements in provider-patient relations should contribute to a better understanding of and response to factors that can affect health care needs of women living with HIV, 90 as well as to adequate postabortion family planning counselling.…”

Section: Service Delivery Implicationsmentioning

confidence: 99%

Reproductive Choice for Women and Men Living with HIV: Contraception, Abortion and Fertility

Delvaux¹,

Nöstlinger

2007

Reproductive Health Matters

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From a policy and programmatic point of view, this paper reviews the literature on the fertility-related needs of women and men living with HIV and how the entry points represented by family planning, sexually transmitted infection and HIV-related services can ensure access to contraception, abortion and fertility services for women and men living with HIV. Most contraceptive methods are safe and effective for HIV positive women and men. The existing range of contraceptive options should be available to people living with HIV, along with more information about and access to emergency contraception. Potential drug interaction must be considered between hormonal contraception and treatment for tuberculosis and certain antiretroviral drugs. Couples living with HIV who wish to use a permanent contraceptive method should have access to female sterilisation and vasectomy in an informed manner, free of coercion. How to promote condoms and dual protection and how to make them acceptable in long term-relationships remains a challenge. Both surgical and medical abortion are safe for women living with HIV. To reduce risk of vertical transmission of HIV and in cases of infertility, people with HIV should have access to sperm washing and other assisted conception methods, if these are available. Simple and cost-effective procedures to reduce risk of vertical transmission should be part of counselling for women and men living with HIV who intend to have children. Support for the reproductive rights of people with HIV is a priority. More operations research on best practices is needed. A2007 Reproductive Health Matters. All rights reserved.

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High Uptake of Postpartum Hormonal Contraception Among HIV-1-Seropositive Women in Kenya

Abstract: Using existing the healthcare infrastructure, it is possible to achieve high levels of postpartum hormonal contraceptive utilization among HIV-1-seropositive women.

Cited by 27 publications

References 13 publications

Contraceptive Use and Method Preference among Women in Soweto, South Africa: The Influence of Expanding Access to HIV Care and Treatment Services

Contraceptive Use and Method Preference among Women in Soweto, South Africa: The Influence of Expanding Access to HIV Care and Treatment Services

Gender, sex, and HIV: how well are we addressing the imbalance?

Reproductive Choice for Women and Men Living with HIV: Contraception, Abortion and Fertility

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