Allen S, Serufilira A, Gruber V, Kegeles S, Van de Perre P, Carael M, Coates TJ. Pregnancy and contraception use among urban Rwandan women after HIV testing and counseling.
Am J Public Health 1993;
83:705-10. [PMID:
8484453 PMCID:
PMC1694707 DOI:
10.2105/ajph.83.5.705]
[Citation(s) in RCA: 114] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES
This study examined hormonal contraceptive use and pregnancy in urban Rwandan women, following human immunodeficiency virus (HIV) antibody testing and counseling.
METHODS
A sample of 1458 childbearing urban Rwandan women aged 18 to 35 years was tested and followed for 2 years.
RESULTS
At enrollment, 17% of 998 HIV-negative women and 11% of 460 HIV-positive women were pregnant, and 17% vs 23%, respectively, were using hormonal contraceptives. One year later, half of the HIV-positive and one third of the HIV-negative hormonal-contraceptive users had discontinued use. The 2-year incidence of pregnancy was 43% in HIV-positive and 58% in HIV-negative women. HIV-positive women with fewer than four children were more likely to become pregnant than those with four or more; this association persisted in multivariate analyses but was not noted among HIV-negative women. At the end of the study, over 40% of non-users said that they would use hormonal contraception if it was provided at the study clinic, but 40% of HIV-positive women desired more children.
CONCLUSIONS
Research is needed to identify the practical and psychosocial obstacles to effective long-term contraception among HIV-positive women. HIV counseling programs must specifically address the issue of childbearing.
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