title: Fertility desires, unmet need for family planning, and unwanted pregnancies among HIV-infected women in care in Kinshasa, DR Congo.
abstract: BACKGROUND
  We assessed the fertility desires, utilization of family planning (FP) methods, and incidence of pregnancies among HIV-infected women receiving care in an HIV clinic with an onsite FP services in Kinshasa, Democratic Republic of Congo.
  
  
  METHODS
  Between November 2011 and May 2012, all HIV-infected women who attended a routine visit at the clinic were interviewed about their fertility desires and utilization of contraceptive methods using a structured questionnaire. Routine follow-up visit data were used to identify pregnancies recorded between the interview and June 2013.
  
  
  RESULTS
  Overall, of the 699 HIV-infected women interviewed. 249 (35.7%) reported not wanting another child. Of the 499 (72.2%) participants who were sexually active at the time of interview, 177 (35.5%) were using an effective contraceptive method, including 70 (14.0%) women who reported using condoms consistently and 104 (20.8%) who were using injectable contraception. Overall, 88 (17.6%) sexually active participants who did not want another child were not using an effective FP method, and thus are considered to have had unmet need. During the median follow-up time of 22.2 (IQR: 20.2, 23.6) months, among all women interviewed, 96 (14.1%) became newly pregnant [pregnancy rate 9.3 (95%CI: 7.6, 11.4) per 100 women-years] including 21 (8.7%) among women who initially reported not wanting another child [unwanted pregnancy rate 5.8 (95%CI: 3.6, 9.3) per 100 women-years].
  
  
  CONCLUSIONS
  The persistence of relatively high unmet need among women receiving HIV care in a clinic with onsite FP services suggests the existence of barriers that must be identified and addressed.
authors.affiliation: Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH; University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC.
authors.forename: Marcel
authors.initials: M
authors.lastname: Yotebieng
authors.affiliation: Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH.
authors.forename: Alison
authors.initials: A
authors.lastname: Norris
authors.affiliation: University of Kinshasa, School of Public Health, Kinshasa, DR Congo.
authors.forename: Jean Lambert
authors.initials: JL
authors.lastname: Chalachala
authors.affiliation: University of Kinshasa, School of Public Health, Kinshasa, DR Congo.
authors.forename: Yori
authors.initials: Y
authors.lastname: Matumona
authors.affiliation: University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC.
authors.forename: Habib Omari
authors.initials: HO
authors.lastname: Ramadhani
authors.affiliation: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC.
authors.forename: Frieda
authors.initials: F
authors.lastname: Behets
mesh_terms: D000328:Adult; D000359:Aftercare; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D015023:Democratic Republic of the Congo; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011275:Pregnancy, Unwanted; D011795:Surveys and Questionnaires
keywords: DR Congo; HIV; contraceptives; family planning; unwanted pregnancy