Determinants of contraceptive choice among women with HIV.
OBJECTIVE
To examine factors associated with contraceptive choice among HIV-infected women.


METHODS
Data for this cross-sectional analysis were derived from baseline visits of 435 participants in an ongoing prospective study of contraception among HIV-infected women in Russia. Participants enrolled in one of four groups: combined oral contraceptives (COCs) along with condoms, depot medroxyprogesterone acetate (DMPA) along with condoms, copper intrauterine device (IUD) along with condoms, or condoms alone.


METHODS
After contraceptive counseling and assessment of medical eligibility to use study methods, participants selected a method. Standardized interviews were used to collect demographic, reproductive and behavioral information.


RESULTS
Most women were eligible to use COCs (89%) and DMPA (94%); 87% of nonpostpartum women were eligible to use the IUD. The method chosen by most women was condoms alone (47%), followed by COCs along with condoms (29%), DMPA along with condoms (20%) and IUD along with condoms (4%). In multivariable analyses, independent predictors of choosing a method highly effective during typical use (COCs, DMPA, or IUD) along with condoms included having at least two births (prevalence ratio = 1.4), postpartum enrollment (prevalence ratio = 1.3), desiring (prevalence ratio = 1.4), or uncertainty about desiring (prevalence ratio = 1.3) a future pregnancy, prior oral contraceptive use (prevalence ratio = 1.3), recent injection drug use (prevalence ratio = 1.3) and never (prevalence ratio = 2.3) or sometimes (prevalence ratio = 1.9) using condoms in the last year.


CONCLUSIONS
Among HIV-infected women, several characteristics that may place women at greater risk for unintended pregnancy and its adverse consequences were associated with choice of highly effective contraceptive methods. These findings may aid in the development of interventions to increase use of effective contraception among HIV-infected women.
Whiteman
Maura K
MK
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. acq5@cdc.gov
Kissin
Dmitry M
DM
Samarina
Anna
A
Curtis
Kathryn M
KM
Akatova
Natalia
N
Marchbanks
Polly A
PA
Jamieson
Denise J
DJ
Martirosyan
Margarita
M
Revzina
Natalya
N
Hillis
Susan D
SD
D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D003273:Contraceptive Devices / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D015497:HIV-1; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012426:Russia; D055815:Young Adult