title: [Dual contraception adherence among HIV-infected women].
abstract: OBJECTIVE
  To determine adherence to dual contraception using depot-medroxyprogesterone acetate (DMPA) and condom among HIV-infected women.
  
  
  METHODS
  A cross-sectional study carried out from December 2013 to September 2014 at a local reference center, with application of questionnaire elaborated after Delphi panel and content validation to 114 HIV(+) women aged 15 to 49 years, using DMPA plus condom for contraception.
  
  
  RESULTS
  Mean age was 33.2 ± 7.2 years, mean time since HIV detection was 8.1 ± 5.2 years, mean time of antiretroviral use was 6.8 ± 5 years and mean CD4 cells/mm3 count was 737.6 ± 341.1. Sexual HIV acquisition was reported by 98.2% (112/114), antiretroviral use by 85.9% (98/114), and 77.7% (84/114) had a CD4>500/mm3 count. Having a single sex partner was reported by 78.9% (90/114), with HIV serodiscordance in 41.2% (47/114) of couples, 21.9% did not know the serological status of their partner and in 37.7% of cases (43/114) the partner was unaware of the HIV(+) status of the woman. The last pregnancy was unplanned in 71.9% of cases (82/114) and 14.9% of the women had become pregnant the year before, with pregnancy being unplanned in 70.5% (12/17) of cases. Current use of DMPA was reported by 64.9% (74/114), with genital bleeding in 48.2% (55/114) and weight gain in 67.5% (77/114). Use of a male condom was reported by 62.2% of the subjects (71/114). Three reported that they always used a female condom and ten that they eventually used it. Unprotected vaginal sex was reported by 37.7% (43/114) and unprotected anal intercourse was reported by 32.4% (37/114). Partner resistance to use a condom occurred in 30.7% of cases (35/114). Dual contraception using DMPA with condom was reported by 42.9% (49/114). A partner who resisted wearing a condom was associated with poor adhesion (PR=0.3; 95%CI 0.2-0.7; p<0.001). A partner who was unaware that a woman was infected with HIV favored adherence (PR=1.8; 95%CI 1.2-2.7; p=0.013).
  
  
  CONCLUSIONS
  The percentage of dual contraception using DMPA plus condom was 42.9%, maintaining unplanned pregnancies and unprotected sex. Resistance of partners to use a condom increased three times the chance of a woman not adhering to dual contraception, and the partner not knowing women's HIV infection almost doubled the chance to adhere to safe contraception.
  
  
  OBJECTIVE
  to offer new hormonal contraceptives and to involve the partners in contraception and serologic detection tests.
authors.affiliation: Escola Bahiana de Medicina e Saúde Humana, Salvador, BA, Brasil.
authors.forename: Karina de Sá Adami Gonçalves
authors.initials: Kde S
authors.lastname: Brandão
authors.affiliation: Escola Bahiana de Medicina e Saúde Humana, Salvador, BA, Brasil.
authors.forename: Bruno Gil de Carvalho
authors.initials: BG
authors.lastname: Lima
authors.affiliation: Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Salvador, BA, Brasil.
authors.forename: Ana Gabriela Álvares
authors.initials: AG
authors.lastname: Travassos
authors.affiliation: Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brasil.
authors.forename: Fabielle de Oliveira Rocha
authors.initials: Fde O
authors.lastname: de Brito
authors.affiliation: Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brasil.
authors.forename: Eveline Xavier Pereira
authors.initials: EX
authors.lastname: de Souza
authors.affiliation: Centro Estadual Especializado em Diagnóstico, Salvador, BA, Brasil.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Haguihara
authors.affiliation: Centro Estadual Especializado em Diagnóstico, Salvador, BA, Brasil.
authors.forename: Carlos Alberto Lima
authors.initials: CA
authors.lastname: da Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms; D003271:Contraceptive Agents, Female; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate