title: Contraceptive use and pregnancy decision making among women with HIV.
abstract: HIV is a growing epidemic among women in the United States. This study seeks to determine if knowledge of HIV infection and of the benefits of prenatal zidovudine (ZDV) to decrease vertical HIV transmission is related to decisions about pregnancy planning, contraceptive and condom use, and pregnancy termination among noninjection drug using (IDU) women with HIV. Eighty-two HIV-infected women were interviewed about their pregnancy decisions, contraceptive and condom use, and pregnancy outcome. Data was verified by structured chart review where available. Awareness of HIV infection or knowledge of the benefits of prenatal ZDV use did not significantly influence pregnancy planning, contraceptive choice, use of contraception, or consideration of pregnancy termination. Condom use was extremely low (14.6% consistent use), the majority of pregnancies (68.0%) were unplanned, contraceptive use was low (50.9%), and few pregnancies were terminated (6.3%). Women on Medicaid were significantly less likely than women with private or no insurance to terminate their pregnancy (2/20, 10% vs. 3/5, 60%, p = 0.04, two-tailed Fisher's exact test). Most women (70.0%) reported the most important reason for carrying the pregnancy to term was the desire for a child. In conclusion, among women in this non-IDU, Midwestern cohort, knowledge of HIV infection was not associated with decisions to plan a pregnancy, use contraception if not planning pregnancy, or terminate an unplanned pregnancy.
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Smits
authors.forename: C A
authors.initials: CA
authors.lastname: Goergen
authors.forename: J A
authors.initials: JA
authors.lastname: Delaney
authors.forename: C
authors.initials: C
authors.lastname: Williamson
authors.forename: L M
authors.initials: LM
authors.lastname: Mundy
authors.forename: V J
authors.initials: VJ
authors.lastname: Fraser
mesh_terms: D000032:Abortion, Therapeutic / Q000523:psychology / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007348:Insurance, Health; D008923:Missouri; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control* / Q000523:psychology*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011795:Surveys and Questionnaires; D014930:Women / Q000193:education* / Q000523:psychology*; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine