BACKGROUND: Long-acting reversible contraceptives (LARCs) and sterilisation are the most cost-effective methods of contraception but are rarely used in sub-Saharan Africa partly due to limited access. STUDY DESIGN: HIV-positive pregnant women attending two urban clinics in Rwanda were followed prospectively in a perinatal HIV transmission cohort study. Women attending one clinic were referred to public family planning (FP) services for all contraceptive methods (Site A) and women attending the other clinic (Site B) were offered implants and intrauterine devices (IUDs) on-site. RESULTS: Fifty three percent of the pregnant women reported an intention to use a LARC or to be sterilised after delivery. The uptake of implants was significantly higher at Site B (38%) than at Site A (6%). The IUD uptake was extremely low at both sites (2%). Twenty-eight of the 39 women at Site B who had intended to start using a LARC actually did so as compared to only one of 23 at Site A. CONCLUSION: When access to LARC was provided, a substantial number of HIV-positive women started using hormonal implants, but not IUDs, in the postpartum period. HIV and FP services should consider improving access to implants to reduce the number of unintended pregnancies.
BACKGROUND: Long-acting reversible contraceptives (LARCs) and sterilisation are the most cost-effective methods of contraception but are rarely used in sub-Saharan Africa partly due to limited access. STUDY DESIGN: HIV-positive pregnant women attending two urban clinics in Rwanda were followed prospectively in a perinatal HIV transmission cohort study. Women attending one clinic were referred to public family planning (FP) services for all contraceptive methods (Site A) and women attending the other clinic (Site B) were offered implants and intrauterine devices (IUDs) on-site. RESULTS: Fifty three percent of the pregnant women reported an intention to use a LARC or to be sterilised after delivery. The uptake of implants was significantly higher at Site B (38%) than at Site A (6%). The IUD uptake was extremely low at both sites (2%). Twenty-eight of the 39 women at Site B who had intended to start using a LARC actually did so as compared to only one of 23 at Site A. CONCLUSION: When access to LARC was provided, a substantial number of HIV-positive women started using hormonal implants, but not IUDs, in the postpartum period. HIV and FP services should consider improving access to implants to reduce the number of unintended pregnancies.
Authors: Lisa B Haddad; Chelsea B Polis; Anandi N Sheth; Jennifer Brown; Athena P Kourtis; Caroline King; Rana Chakraborty; Igho Ofotokun Journal: Curr HIV/AIDS Rep Date: 2014-12 Impact factor: 5.071
Authors: Naw H Khu; Bellington Vwalika; Etienne Karita; William Kilembe; Roger A Bayingana; Deborah Sitrin; Heidi Roeber-Rice; Emily Learner; Amanda C Tichacek; Lisa B Haddad; Kristin M Wall; Elwyn N Chomba; Susan A Allen Journal: Contraception Date: 2012-11-12 Impact factor: 3.375
Authors: Céline Schurmans; Irith De Baetselier; Evelyne Kestelyn; Vicky Jespers; Thérèse Delvaux; Stephen K Agaba; Harry van Loen; Joris Menten; Janneke van de Wijgert; Tania Crucitti Journal: BMC Public Health Date: 2015-04-10 Impact factor: 3.295
Authors: Mufida M Shabiby; Joseph G Karanja; Francis Odawa; Rose Kosgei; Minnie W Kibore; James N Kiarie; John Kinuthia Journal: BMC Womens Health Date: 2015-08-19 Impact factor: 2.809