Contraception and fertility plans in a cohort of HIV-positive women in care.
OBJECTIVE
The aim of this study was to examine determinants of contraceptive use, desired future childbearing and sterilization regret among HIV-positive women.


METHODS
One hundred eighteen HIV-positive women, age 18-46, receiving care at a university HIV clinic completed a survey on their reproductive history in 2004. We reviewed their medical records for contraception, antiretroviral medications and HIV/AIDS disease markers. We performed descriptive analysis of population characteristics and logistic regression to assess predictors of their desire to have future children.


RESULTS
Subjects had a median age of 37 years and had been diagnosed with HIV for a mean of 9.2 years; 55% had AIDS. Most (68%) subjects were currently monogamous and 29% were abstinent. Forty-seven percent had been sterilized and of those who were sexually active but not sterilized, 90% were using reversible contraception. One third of subjects desired future childbearing, including 12% of those who had been previously sterilized. In a multivariate analysis, predictors of desire for future childbearing were younger age, not being on HIV medication, higher current CD4 cell count and having a relationship duration of less than 2 years.


CONCLUSIONS
HIV-positive women have reproductive patterns similar to those of HIV-negative women, with most having borne children and many wanting children in the future. A substantial proportion has been sterilized and express sterilization regret. Potent antiretroviral therapy has greatly improved the outlook for HIV-infected women, even those with an AIDS diagnosis. Many HIV-positive women want to have children and would benefit from preconception counseling and counseling about reversible methods of contraception.
Stanwood
Nancy L
NL
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Box 668, Rochester, NY 14642-8558, USA. nancy_stanwood@urmc.rochester.edu
Cohn
Susan E
SE
Heiser
Jennifer R
JR
Pugliese
MaryAnn
M
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003268:Contraception Behavior / Q000523:psychology*; D003271:Contraceptive Agents, Female; D003273:Contraceptive Devices; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D013246:Sterilization, Tubal / Q000706:statistics & numerical data*
D003271:Contraceptive Agents, Female