title: Contraception use, family planning, and unprotected sex: few differences among HIV-infected and uninfected postpartum women in four US states.
abstract: To describe pregnancy intentions and contraceptive use among a postpartum sample of women with and at risk for HIV infection, 258 HIV-seropositive and 228 HIV-seronegative women were recruited from prenatal clinics in 4 US states between June 1996-November 1998. Participants completed interviews at 24-40 weeks' gestation and at 6 months postpartum. At the 6-month interview, 78% of women reported vaginal sex, and 2% were pregnant. Among those not pregnant, 86% said that there was no likelihood of a pregnancy in the next 6 months. Condom use was reported by 68% of sexually active women; 65% of users reported consistent use. Those with HIV were more likely to report condom use, more likely to report condom use consistency, and less likely to report use of oral contraceptives than women without HIV (P < 0.05). In multivariate analysis, inconsistent condom use was associated with postpartum alcohol use (odds ratio [OR] 2.80; 95% CI = 1.34-5.84), with the respondent stating that a pregnancy would not be emotionally upsetting (OR 3.06; 95% CI = 1.41-6.59) and reporting an intention to terminate a pregnancy if one were to occur (OR 3.47; 95% CI = 1.58-7.60). HIV-seropositive women who had at least 1 child with HIV infection were less likely than seronegative women to report inconsistent condom use (OR 0.15; 95% CI = 0.03-0.76). Few differences were detected in reproductive behaviors as a function of HIV serostatus, although both cohorts engaged in unprotected sex. Counseling to decrease sexual risk behaviors should begin prior to or early in the postpartum period and include discussion of both reproductive and disease transmission issues.
authors.affiliation: State University of New York, Downstate Medical Center, Brooklyn, New York 11203, USA. Tracey.Wilson@Downstate.edu
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
authors.forename: Linda
authors.initials: L
authors.lastname: Koenig
authors.forename: Jeannette
authors.initials: J
authors.lastname: Ickovics
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Walter
authors.forename: Amy
authors.initials: A
authors.lastname: Suss
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003267:Contraception / Q000706:statistics & numerical data*; D003276:Contraceptives, Oral; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D018873:Pregnancy Rate; D021841:Safe Sex / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D003276:Contraceptives, Oral