title: Medical eligibility, contraceptive choice, and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe, Malawi.
abstract: OBJECTIVE
  To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART).
  
  
  METHODS
  All HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants.
  
  
  RESULTS
  The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day.
  
  
  CONCLUSIONS
  Most methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women.
authors.affiliation: Emory University, Department of Gynecology and Obstetrics, Atlanta, USA. Electronic address: lbhadda@emory.edu.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Haddad
authors.affiliation: The Lighthouse Trust, Lilongwe, Malawi; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, USA.
authors.forename: Caryl
authors.initials: C
authors.lastname: Feldacker
authors.affiliation: Emory University, Department of Gynecology and Obstetrics, Atlanta, USA.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.affiliation: The Lighthouse Trust, Lilongwe, Malawi.
authors.forename: Hannock
authors.initials: H
authors.lastname: Tweya
authors.affiliation: Emory University, Department of Gynecology and Obstetrics, Atlanta, USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Cwiak
authors.affiliation: University of North Carolina-Chapel Hill, Chapel Hill, USA.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Bryant
authors.affiliation: University of North Carolina-Chapel Hill, Chapel Hill, USA; University of North Carolina Project-Malawi, Lilongwe, Malawi.
authors.forename: Mina C
authors.initials: MC
authors.lastname: Hosseinipour
authors.affiliation: The Lighthouse Trust, Lilongwe, Malawi.
authors.forename: Thomas
authors.initials: T
authors.lastname: Chaweza
authors.affiliation: The Lighthouse Trust, Lilongwe, Malawi.
authors.forename: Linly
authors.initials: L
authors.lastname: Mlundira
authors.affiliation: Reproductive Health Services, Ministry of Health, Lilongwe, Malawi.
authors.forename: Fanny
authors.initials: F
authors.lastname: Kachale
authors.affiliation: University of North Carolina-Chapel Hill, Chapel Hill, USA.
authors.forename: Gretchen S
authors.initials: GS
authors.lastname: Stuart
authors.affiliation: University of North Carolina-Chapel Hill, Chapel Hill, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hoffman
authors.affiliation: The Lighthouse Trust, Lilongwe, Malawi.
authors.forename: Sam
authors.initials: S
authors.lastname: Phiri
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D002755:Choice Behavior; D003268:Contraception Behavior; D004608:Eligibility Determination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007435:Intrauterine Devices, Copper; D008295:Malawi; D010342:Patient Acceptance of Health Care
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral therapy; Contraception; HIV; Intrauterine contraception; Intrauterine device; Malawi; Medical eligibility