Knowledge, use, and concerns about contraceptive methods among sero-discordant couples in Rwanda and Zambia.
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.
Grabbe
Kristina
K
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Stephenson
Rob
R
Vwalika
Bellington
B
Ahmed
Yusuf
Y
Vwalika
Cheswa
C
Chomba
Elwyn
E
Karita
Etienne
E
Kayitenkore
Kayitesi
K
Tichacek
Amanda
A
Allen
Susan
S
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
D003270:Contraceptive Agents