Lisa B Haddad1, Caryl Feldacker2, Denise J Jamieson3, Hannock Tweya4, Carrie Cwiak3, Amy G Bryant5, Mina C Hosseinipour6, Thomas Chaweza4, Linly Mlundira4, Fanny Kachale7, Gretchen S Stuart5, Irving Hoffman5, Sam Phiri4. 1. Emory University, Department of Gynecology and Obstetrics, Atlanta, USA. Electronic address: lbhadda@emory.edu. 2. The Lighthouse Trust, Lilongwe, Malawi; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, USA. 3. Emory University, Department of Gynecology and Obstetrics, Atlanta, USA. 4. The Lighthouse Trust, Lilongwe, Malawi. 5. University of North Carolina-Chapel Hill, Chapel Hill, USA. 6. University of North Carolina-Chapel Hill, Chapel Hill, USA; University of North Carolina Project-Malawi, Lilongwe, Malawi. 7. Reproductive Health Services, Ministry of Health, Lilongwe, Malawi.
Abstract
OBJECTIVE: To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART). METHODS: All HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants. RESULTS: The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day. CONCLUSION: Most methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women.
OBJECTIVE: To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infectedwomen receiving antiretroviral therapy (ART). METHODS: All HIV-infectedwomen who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants. RESULTS: The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day. CONCLUSION: Most methods of contraception are safe for use by HIV-infectedwomen. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infectedwomen.
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