title: Dual contraceptive method use and pregnancy intention among people living with HIV receiving HIV care at six hospitals in Thailand.
abstract: BACKGROUND
  Describe dual contraceptive method use and the intention to become pregnant of people living with HIV (PLHIV) and their partners in Thailand.
  
  
  METHODS
  From January 2008-March 2009, we systematically selected a cohort of PLHIV from PLHIV seeking care at five tertiary care hospitals and one community hospital to complete a questionnaire assessing sexual activity, intention to become pregnant, and contraceptive practices at baseline and 12 months after enrollment. Participants received short family planning messages every 2-3 months to promote the use of dual contraceptives and were offered family planning services.
  
  
  RESULTS
  A total of 1,388 PLHIV enrolled, their median age was 37 years (IQR 33-43), 898 (64.7%) had a steady partner, and 737 (53.1%) were male. Among those with a steady partner, 862 (96.0%) did not intend to become pregnant; 709 (82.3%) had sex during the previous 3 months, 683 (96.3%) used at least one contraceptive method, and 202 (29.6%) used dual contraceptive methods. Of the 317 PLHIV who used a single contraceptive method at baseline, 66 (20.8%) reported using dual methods at 12 months. Participants at two tertiary care hospitals where coordinators facilitated PLHIV referral between HIV and OB/GYN clinics were more likely than participants at the other hospitals to change from single method to dual method (p ≤ 0.03).
  
  
  CONCLUSIONS
  Few PLHIV in this study intended to become pregnant; however, only one-fourth used dual contraceptive methods. Integrating an assessment of the intention to become pregnant and strengthening the PLHIV referral systems in family planning services may contribute to higher rates of dual contraceptive use.
authors: Faculty of Medicine Vajira Hospital, Navamindharadhiraj University, Bangkok, Thailand.
authors: Warangkana
authors: W
authors: Munsakul
authors: Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000, Thailand. hpu8@cdc.gov.
authors: Rangsima
authors: R
authors: Lolekha
authors: Bamrasnaradura Infectious Disease Institute, Nonthaburi, Thailand.
authors: Boonchai
authors: B
authors: Kowadisaiburana
authors: Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors: Anuvat
authors: A
authors: Roongpisuthipong
authors: Taksin Hospital, Bangkok, Thailand.
authors: Supannee
authors: S
authors: Jirajariyavej
authors: Rajavithi Hospital, Bangkok, Thailand.
authors: Suvanna
authors: S
authors: Asavapiriyanont
authors: Wiang Pa Pao Hospital, Chiang Rai, Thailand.
authors: Ubonsri
authors: U
authors: Hancharoenkit
authors: Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000, Thailand.
authors: Benjamas
authors: B
authors: Baipluthong
authors: Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000, Thailand.
authors: Sarika
authors: S
authors: Pattanasin
authors: Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000, Thailand.|Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, USA.
authors: Michael
authors: M
authors: Martin
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D015331:Cohort Studies; D003268:Contraception Behavior / Q000208:ethnology; D000069216:Contraceptive Prevalence Surveys; D005193:Family Planning Services / Q000193:education; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology; D006679:HIV Seropositivity / Q000208:ethnology; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010349:Patient Compliance / Q000208:ethnology; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D043762:Reproductive Behavior / Q000208:ethnology; D012747:Sexual Partners; D062606:Tertiary Care Centers; D013785:Thailand