Reproductive and contraceptive attitudes as predictors of condom use among women in an HIV prevention intervention.

This study prospectively evaluates the effect of childbearing motivation and contraceptive attitudes on consistency of condom use among at-risk women enrolled in an HIV prevention intervention. Women (age 15-40, 85% African-American) were recruited from homeless shelters, drug treatment facilities, and public housing developments and assigned to standard or enhanced intervention conditions. Among the eligible study group of nonsterilized women with a main partner (n = 312), 24.4% wanted to have a baby at baseline; 43.5% believed their partner wanted them to have a baby. Women who reported a desire for a baby, compared to all others, were less likely to be at a higher level of condom consistency six months later (OR = 0.66; .48-.90). Women who perceived partner support for contraceptive use showed a higher level of condom consistency (OR = 1.20; 1.03-1.41) at 6-month follow-up. Many women in this study wanted to have a baby and this desire interfered with subsequent consistency of condom use. We also found that condom use increased toward consistency of use among women whose partner supported contraceptive use. HIV prevention interventions should include screening for reproductive motivation, so that prevention messages can be tailored to the realities of women's lives. Women who want a baby can be educated about disease prevention in the context of pregnancy planning and linked with appropriate services. Women who want to avoid childbearing can be given messages that emphasize the contraceptive benefits of condom use and that help strengthen partner support.