dc.description.abstract |
Despite risks of HIV transmission to infants born of the HIV positive women, contraceptive
use is uncommon among women in HIV discordant partnerships. The
aim of this study was to determine the factors associated with contraceptive use
in a clinical trial cohort of HIV serodiscordant couples based in Thika and Eldoret,
Kenya. Data were analyzed from 481 HIV discordant couples enrolled in the Partners
in Prevention HSV/HIV Transmission Study at the Thika and Eldoret sites.
The primary study outcome was self-reported use of contraception other than
condoms. Using a marginal longitudinal logistic model based on generalized estimating
equations (GEE) approach we assessed the association of various demographic
and behavioral factors with contraceptive use. At baseline the prevalence
of non barrier contraceptive use among HIV positive and negative women was
24.3% and 25.7%, respectively. At month 12 of follow-up, the prevalence of
contraceptive use was 44.4% among the HIV positive and 26% among the HIV
negative women while at month 24, the prevalence of contraceptive use was
38.6% among the HIV positive and 18.2% among the HIV negative women. HIV
positive women were more likely to report using contraception than HIV negative
women (odds ratio (OR) 1.61 95% confidence interval (CI) 1.04-2.47). Additionally,
being married (OR 2.4, 95% CI 1.2-5.0), attending Thika site clinic (OR 6.1,
95% CI 4.2-9.0), and having two or more children (OR 1.9, 95% CI 1.3-2.8)
were significantly associated with use of non barrier contraceptives. Future programs
should focus on interventions to increase contraceptive use among HIV
serodiscordant couples, with a special emphasis on HIV negative women, unmarried
women and women with few children. |
en_US |