Article Text

Download PDFPDF
Impact of learning HIV status on contraceptive use in the MIRA trial
  1. Kelly Blanchard1,
  2. Kelsey Holt2,
  3. Alan Bostrom3,
  4. Ariane van der Straten4,
  5. Gita Ramjee5,
  6. Guy de Bruyn6,
  7. Tsungai Chipato7,
  8. Elizabeth T Montgomery8,
  9. Nancy S Padian9
  1. 1President, Ibis Reproductive Health, Cambridge, MA, USA
  2. 2Senior Project Manager, Ibis Reproductive Health, Cambridge, MA, USA
  3. 3Specialist, University of California, San Francisco, CA, USA
  4. 4Senior Research Scientist, Women's Global Health Imperative, RTI International, San Francisco, CA, USA
  5. 5Director, HIV Prevention Research Unit, Medical Research Council, Durban, South Africa
  6. 6Programme Director for HIV Prevention Studies, Perinatal HIV Research Unit, Johannesburg, South Africa
  7. 7Professor of Obstetrics and Gynecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
  8. 8Research Public Health Analyst, Women's Global Health Imperative, RTI International, San Francisco, CA, USA
  9. 9Adjunct Professor, School of Public Health, University of California, Berkeley, CA, USA
  1. Correspondence to Kelsey Holt, Ibis Reproductive Health, 17 Dunster Street Suite 201, Cambridge, MA 02138, USA; kholt{at}ibisreproductivehealth.org

Abstract

Background and methodology We examined the effect of becoming HIV-positive on contraceptive practices in a Phase III randomised controlled trial of the diaphragm for HIV prevention. We coded self-reported contraceptive use into seven categories of methods in order of effectiveness. We compared the proportion using each category of contraception at baseline and last visit between women who did and did not become HIV-positive. We compared changes in the proportion using each category of contraception from baseline to last visit and calculated the percentage of women that moved to a more or less effective method category or stayed the same. We examined immediate and long-term changes in contraceptive use category after learning HIV-positive status.

Results A total of 4645 women remained HIV-negative and 309 became HIV-positive. The proportion using each category of contraception was similar between groups at baseline and last visit. In both groups approximately one-fifth changed to a less effective method category between baseline and last visit. Few women reported using long-acting methods. Among HIV-positive women, shorter-term changes in the proportion using each category of contraception were similar to longer-term changes, though somewhat more women were using a method in the same category 3 months after seroconversion.

Discussion and conclusions Learning about HIV-positive status did not appear to significantly change patterns of use of effective contraceptives or the probability of switching to a more or less effective method. Information about, and access to, long-acting methods should receive more attention and be a routine part of family planning programmes and prevention trials.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Funding This work was funded by a grant (#21082) from the Bill and Melinda Gates Foundation to the University of California, San Francisco, CA, USA.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.