title: Knowledge, use, and concerns about contraceptive methods among sero-discordant couples in Rwanda and Zambia.
abstract: OBJECTIVE
  The unique needs of sero-discordant couples are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in absence of the reduction of the risk of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Conversely, HIV testing and programs focus exclusively on condom use without discussion of more effective contraceptive methods. In order to provide information to inform the development of family planning services tailored to the unique needs of sero-discordant couples, this study examined the contraceptive knowledge, use, and concerns among sero-discordant couples in urban Rwanda and Zambia.
  
  
  METHODS
  This article presents a comparison of family planning knowledge, use, and concerns about contraception among two cohorts of HIV sero-discordant study participants in Rwanda and Zambia.
  
  
  RESULTS
  The results reveal an interesting profile of contraceptive knowledge and use among sero-discordant couples; in both settings, despite high levels of knowledge of contraception, use of contraceptive methods remains relatively low. There is a clear gender difference in both the reporting of knowledge and use of contraceptive methods, and there is evidence of clandestine contraceptive use by women.
  
  
  CONCLUSIONS
  Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet to needs and concerns of HIV-positive women or those with HIV positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on "dual method use," combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Grabbe
authors.forename: Rob
authors.initials: R
authors.lastname: Stephenson
authors.forename: Bellington
authors.initials: B
authors.lastname: Vwalika
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ahmed
authors.forename: Cheswa
authors.initials: C
authors.lastname: Vwalika
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.forename: Etienne
authors.initials: E
authors.lastname: Karita
authors.forename: Kayitesi
authors.initials: K
authors.lastname: Kayitenkore
authors.forename: Amanda
authors.initials: A
authors.lastname: Tichacek
authors.forename: Susan
authors.initials: S
authors.lastname: Allen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003267:Contraception / Q000379:methods* / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology*; D003270:Contraceptive Agents / Q000008:administration & dosage; D003376:Counseling / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012432:Rwanda; D012747:Sexual Partners / Q000523:psychology*; D011795:Surveys and Questionnaires; D015024:Zambia
chemical_list: D003270:Contraceptive Agents