title: Pregnancy and contraception use among urban Rwandan women after HIV testing and counseling.
abstract: OBJECTIVE
  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.
authors: Center for AIDS Prevention Studies, Division of General Internal Medicine, University of California, San Francisco.
authors: S
authors: S
authors: Allen
authors: A
authors: A
authors: Serufilira
authors: V
authors: V
authors: Gruber
authors: S
authors: S
authors: Kegeles
authors: P
authors: P
authors: Van de Perre
authors: M
authors: M
authors: Carael
authors: T J
authors: TJ
authors: Coates
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D001290:Attitude; D003268:Contraception Behavior; D003376:Counseling; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D015999:Multivariate Analysis; D011247:Pregnancy; D012432:Rwanda; D012494:Sampling Studies