TY - JOUR
T1 - From Pill to Condom, or Nothing at all
T2 - HIV Diagnosis and Discontinuation of Highly Effective Contraceptives Among Women in Northeast Brazil
AU - Stifani, Bianca M.
AU - MacCarthy, Sarah
AU - Nunn, Amy
AU - Benfield, Nerys
AU - Dourado, Inês
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - This is a cross-sectional study examining highly effective contraceptive (HEC) use among HIV-positive women in Salvador, Brazil. We used multivariate logistic regression to look for predictors of alternative contraceptive choices among women who discontinued HEC after HIV diagnosis. Of 914 participants surveyed, 38.5% of participants used HEC before but not after diagnosis. Of these, 65.9% used condoms alone; 19.3% used no protection; and 14.8% reported abstinence. Use of condoms alone was associated with a history of other sexually transmitted infections (AOR 2.18, 95% CI 1.09–4.66, p = 0.029). Abstinence was associated with recent diagnosis (AOR 8.48, 95% CI 2.20–32.64, p = 0.002). Using no method was associated with age below 25 (AOR 5.13, 95% CI 1.46–18.00, p = 0.011); income below minimum wage (AOR 2.54, 95% CI 1.31–4.92, p = 0.006); HIV-positive partner status (AOR 2.69, 95% CI 1.03–7.02, p = 0.043); and unknown partner status (AOR 2.90, 95% CI 1.04–8.05, p = 0.042). Improved contraceptive counseling is needed after HIV diagnosis. Continuation of HEC should be encouraged for women wishing to prevent pregnancy, and may increase contraceptive coverage among HIV-positive women.
AB - This is a cross-sectional study examining highly effective contraceptive (HEC) use among HIV-positive women in Salvador, Brazil. We used multivariate logistic regression to look for predictors of alternative contraceptive choices among women who discontinued HEC after HIV diagnosis. Of 914 participants surveyed, 38.5% of participants used HEC before but not after diagnosis. Of these, 65.9% used condoms alone; 19.3% used no protection; and 14.8% reported abstinence. Use of condoms alone was associated with a history of other sexually transmitted infections (AOR 2.18, 95% CI 1.09–4.66, p = 0.029). Abstinence was associated with recent diagnosis (AOR 8.48, 95% CI 2.20–32.64, p = 0.002). Using no method was associated with age below 25 (AOR 5.13, 95% CI 1.46–18.00, p = 0.011); income below minimum wage (AOR 2.54, 95% CI 1.31–4.92, p = 0.006); HIV-positive partner status (AOR 2.69, 95% CI 1.03–7.02, p = 0.043); and unknown partner status (AOR 2.90, 95% CI 1.04–8.05, p = 0.042). Improved contraceptive counseling is needed after HIV diagnosis. Continuation of HEC should be encouraged for women wishing to prevent pregnancy, and may increase contraceptive coverage among HIV-positive women.
KW - Contraceptive methods
KW - Contraceptive usage
KW - HIV seropositivity
KW - Women
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U2 - 10.1007/s10461-017-1846-y
DO - 10.1007/s10461-017-1846-y
M3 - Article
C2 - 28688030
AN - SCOPUS:85021933863
SN - 1090-7165
VL - 22
SP - 663
EP - 670
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 2
ER -