Abstract
Objective
We examined contraceptive use and dual protection in the postpartum period in a Prevention
of Mother to Child Transmission population and whether it varied by HIV status.
Study design
Data are from a prospective study, the South Africa HIV Antenatal Post-test Support
Study. Pregnant participants were recruited from a government clinic in an urban township,
and the analytic sample was 821. Following enrollment, participants were tested for
HIV and administered a questionnaire at baseline and 14 weeks postpartum. We used generalized linear regression models to examine HIV status
and use of modern contraceptives at 14 weeks.
Results
The risk ratio of condom use at 14 weeks postpartum was 1.66 [95% confidence interval (CI): 1.36–2.02] for HIV-positive
compared to HIV-negative women. The risk ratio for dual protection (use of a condom
and a hormonal method) was 1.96 (95% CI: 1.39–2.79) at 14 weeks for HIV-positive compared to HIV-negative women.
Conclusions
HIV positive status may be a motivating factor for women to use condoms and dual protection.
In this setting where HIV is highly prevalent, it is ever more important that women
control the timing and limiting of births so as to preserve the health of the mother
and child.
Implication
HIV status may be an important motivating behavioral factor for women to use contraceptives
and dual protection in the postpartum period.
Keywords
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References
- Report on the global AIDS epidemic.UNAIDS, Geneva2010
- Nelson Mandela/HSRC Study of HIV/AIDS Household Survey.Human Sciences Research Council, Pretoria2002
- South Africa Demographic and Health Survey 2003.Department of Health, Pretoria2007 ([2003])
- The South African fertility decline. Evidence from two censuses and a demographic and health survey.Popul Stud. 2003; 57: 265-283
- Trends in South African fertility between 1970 and 1998.An Analysis of the 1996 Census and the 1998 Demographic Health Survey. Burden of Disease Research Unit, Medical Research Council, Cape Town2002
- Contraception to prevent HIV-positive births: current contribution and potential cost savings in PEPFAR countries.Sex Transm Infect. 2008; 84: ii49-ii53
- Pregnancy and contraception use among urban Rwandan women after HIV testing and counseling.Am J Public Health. 1993; 83: 705-710
- Safer sex and reproductive choice: findings from ‘Positive Women-Voices and Choices' in Zimbabwe.Reprod Health Matters. 2003; 11: 162-173
- ‘‘Life is still going on": reproductive intentions among HIV-positive women and men in South Africa.Soc Sci Med. 2007; 65: 274-283
- Antiretroviral therapy is associated with increased fertility desire, but not pregnancy or live birth, among HIV+ women in an early HIV treatment program in rural Uganda.AIDS Behav. 2009; 13: 28-37
- Sexual behavior, fertility desires and unmet need for family planning among home-based care clients and caregivers in Kenya.AIDS Care. 2008; 20: 1057-1065
- The impact of HIV on family size preference in Zambia.Reprod Health Matters. 2000; 8: 77-86
- Is there evidence for behaviour change in response to AIDS in rural Zimbabwe?.Soc Sci Med. 1998; 46: 321-330
- HIV Status, Fertility Intentions, and the Demand for Contraception: Assessing the Current Research to Improve the Integration of Reproductive Health and HIV Programs.in: Rutenberg N. Annual meeting of the Population Association of America. 2006 ([Los Angeles, California])
- The year-long effect of HIV-positive test results on pregnancy intentions, contraceptive use, and pregnancy incidence among Malawian women.J Acquir Immune Defic Syndr. 2008; 47: 477-483
- Messages about dual protection in areas of high HIV prevalence are not heeded.S Afr Med J. 2008; 98: 209-212
- Family planning among HIV positive and negative Prevention of Mother to Child Transmission (PMTCT) clients in a resource poor setting in South Africa.AIDS Behav. 2009; 13: 973-979
- Statistical Software: Release 11.StataCorp, College Station, TX2008
- Contraception among HIV concordant and discordant couples in Zambia: a randomized controlled trial.J Women's Health. 2007; 16: 1200-1210
- Peripartum contraceptive attitudes and practices.Contraception. 2004; 70: 383-386
- Factors associated with contraceptive choice and inconsistent method use, United States 2004.Perspect Sex Reprod Health. 2008; 40: 94-104
- Does choice make a differnce to contraceptive use? Evidence from East Java.Stud Fam Plan. 1991; 22: 384-390
Article info
Publication history
Published online: September 18, 2014
Accepted:
September 15,
2014
Received in revised form:
September 8,
2014
Received:
May 2,
2014
Footnotes
☆The authors have no financial or other conflicts of interest.
☆☆This research was funded by the National Institute of Child Health and Human Development grant number: NICHD, 1-R01-HD050134-01A2.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
