title: Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai.
abstract: BACKGROUND
  Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program's potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people.
  
  
  OBJECTIVE
  To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV.
  
  
  METHODS
  A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire.
  
  
  RESULTS
  In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV).
  
  
  CONCLUSIONS
  Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India.
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Beena
authors.initials: B
authors.lastname: Joshi
authors.affiliation: Department of Community Medicine, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India.
authors.forename: Gajanan
authors.initials: G
authors.lastname: Velhal
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Chauhan
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Ragini
authors.initials: R
authors.lastname: Kulkarni
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Shahina
authors.initials: S
authors.lastname: Begum
authors.affiliation: Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
authors.forename: Y S
authors.initials: YS
authors.lastname: Nandanwar
authors.affiliation: Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
authors.forename: Michelle
authors.initials: M
authors.lastname: Fonseca
authors.affiliation: Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Baweja
authors.affiliation: Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Turbadkar
authors.affiliation: Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Ramchandran
authors.affiliation: Department of Obstetrics and Gynaecology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India.
authors.forename: Asha
authors.initials: A
authors.lastname: Dalal
authors.affiliation: Department of Microbiology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India.
authors.forename: Jayanti
authors.initials: J
authors.lastname: Shastri
authors.affiliation: Department of Microbiology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India.
authors.forename: Sachee
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Manisha
authors.initials: M
authors.lastname: Panhale
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Vasundhara
authors.initials: V
authors.lastname: More
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Pravin
authors.initials: P
authors.lastname: Sanap
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Renuka
authors.initials: R
authors.lastname: Panchal
authors.affiliation: Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Kanougiya
keywords: Contraception; HIV; dual methods; dual protection