Nicholas Teodoro1, Annie Fu1, N Tanya Ohly2, Noga Shalev3, Dara Matseoane-Peterssen1, Carolyn L Westhoff4. 1. Department of Obstetrics & Gynecology, Columbia University Irving Medical Center, New York, NY 10032. 2. Department of Obstetrics and Gynecology, New York City Health and Hospitals| Kings County, Brooklyn, NY 11203. 3. Department of Medicine, Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY 10032. 4. Department of Obstetrics & Gynecology, Columbia University Irving Medical Center, New York, NY 10032. Electronic address: clw3@cumc.columbia.edu.
Abstract
OBJECTIVE(S): To describe differences in contraceptive knowledge, attitudes and use among HIV-infected and HIV-uninfected women served by an academic medical center in New York City and to describe gaps in knowledge and practice of gynecologic and HIV clinicians providing care at the same clinic sites where patients completed surveys. STUDY DESIGN: We conducted a survey comparing contraceptive knowledge, attitudes, reproductive histories and long-acting reversible contraception (LARC) use in HIV-infected and -uninfected women. We also conducted a survey to elicit clinician demographic characteristics and education, contraceptive practice patterns and their knowledge of current contraceptive guidelines. We surveyed clinicians and patients at five ambulatory sites. RESULTS: We screened 90% of patients approached. All 257 women who were eligible completed a survey. These included 107 (42%) HIV-infected women and 150 (58%) HIV-uninfected women. HIV-infected women were older, were more likely to be black/African-American, were less likely to be Latina, were more likely to receive public assistance and had lower educational attainment. HIV-infected women reported lower lifetime LARC use (12% vs. 28%) and higher recent condom use (58% vs. 25%) than HIV-uninfected women. Both groups reported similar attitudes toward intrauterine devices (IUDs) and implants. HIV clinicians were less likely to have had training in or discuss LARC methods with their patients. CONCLUSIONS: HIV-infected women were less likely to be current (last 30 days) or ever LARC users, despite having similar attitudes toward IUDs and implants, compared to HIV-uninfected women. HIV providers had lower levels of knowledge of HIV-specific contraceptive guidelines compared with gynecology practitioners. IMPLICATIONS: HIV-infected women and their providers share a knowledge gap regarding LARC. Increased interdisciplinary collaboration may help mitigate the resulting disparities in access to highly effective contraception in HIV-infected women. Knowledge of HIV-specific contraceptive guidelines and ability to place contraceptive implants were low among all surveyed providers, suggesting need for additional training.
OBJECTIVE(S): To describe differences in contraceptive knowledge, attitudes and use among HIV-infected and HIV-uninfectedwomen served by an academic medical center in New York City and to describe gaps in knowledge and practice of gynecologic and HIV clinicians providing care at the same clinic sites where patients completed surveys. STUDY DESIGN: We conducted a survey comparing contraceptive knowledge, attitudes, reproductive histories and long-acting reversible contraception (LARC) use in HIV-infected and -uninfected women. We also conducted a survey to elicit clinician demographic characteristics and education, contraceptive practice patterns and their knowledge of current contraceptive guidelines. We surveyed clinicians and patients at five ambulatory sites. RESULTS: We screened 90% of patients approached. All 257 women who were eligible completed a survey. These included 107 (42%) HIV-infectedwomen and 150 (58%) HIV-uninfectedwomen. HIV-infectedwomen were older, were more likely to be black/African-American, were less likely to be Latina, were more likely to receive public assistance and had lower educational attainment. HIV-infectedwomen reported lower lifetime LARC use (12% vs. 28%) and higher recent condom use (58% vs. 25%) than HIV-uninfectedwomen. Both groups reported similar attitudes toward intrauterine devices (IUDs) and implants. HIV clinicians were less likely to have had training in or discuss LARC methods with their patients. CONCLUSIONS:HIV-infectedwomen were less likely to be current (last 30 days) or ever LARC users, despite having similar attitudes toward IUDs and implants, compared to HIV-uninfectedwomen. HIV providers had lower levels of knowledge of HIV-specific contraceptive guidelines compared with gynecology practitioners. IMPLICATIONS: HIV-infectedwomen and their providers share a knowledge gap regarding LARC. Increased interdisciplinary collaboration may help mitigate the resulting disparities in access to highly effective contraception in HIV-infectedwomen. Knowledge of HIV-specific contraceptive guidelines and ability to place contraceptive implants were low among all surveyed providers, suggesting need for additional training.
Authors: Anandi N Sheth; Christine D Angert; Lisa B Haddad; C Christina Mehta; Susan E Cohn Journal: Contraception Date: 2020-11-12 Impact factor: 3.375
Authors: Sofía L Carbone; Melissa Guillen; Jaime J Ramirez; Sara E Vargas; Connie Fei Lu; Melissa L Getz; Yaa Frimpong; Kelley A Smith; Claire Stout; Iris Tong; Melanie Hill; Robert E Berry; Abigail Harrison; Kate M Guthrie Journal: Sex Health Date: 2020-06 Impact factor: 2.706