predicting contraceptive use among women at risk for or infected with hiv.

NLM AIDSLINE Predicting contraceptive use among women at risk for or infected with HIV. Galavotti C; Cabral R; Garguillo P; Green B; Gielen A; Fogarty L;
January 30, 1997

Int Conf AIDS. 1996 Jul 7-12;11(2):242 (abstract no. Th.D.240). Unique Objective: One component of an effective strategy to prevent the spread of HIV in women and infants is the prevention of unplanned pregnancies in women at risk for infection or transmission. This study identifies factors associated with consistent contraceptive use among women at risk for or infected with HIV. Methods: Data are from structured interviews conducted from March 1993 through October 1994 with women, ages 15-44, in four drug treatment facilities, two homeless shelters, and four non-traditional family planning clinics, and with women infected with HIV in two hospital-based HIV clinics. 628 women at high risk for infection due to their drug use or sexual behavior, and 153 women living with HIV infection, who were neither pregnant, nor sterilized, nor trying to become pregnant at the time of the interview were included in the analysis. Results: More than half of the women had a history of STDs, and 30%-40% had exchanged sex for drugs, money, or other things. 69% of the women at high risk, and 46% of the HIV+ women, had used illicit drugs in the last 6 months; 57% and 41%, respectively, were in drug treatment. 39% of women at risk reported using contraception consistently (all the time with all partners), compared to 62% of HIV+ women. Using logistic regression to adjust for confounding, the following factors were associated with consistent contraceptive use: among women at risk, confidence in one's ability to use (self-efficacy) (OR=1.5, p is less than .001), perceived advantages of use (OR=1.4, P is less than .05), perceived partner support for use (OR=1.3, p is less than .01), and perceived positive social norms (OR=1.4, p is less than .01); in the smaller sample of HIV+ women, only current enrollment in drug treatment was significantly associated with consistent use (OR=7.8, p is less than .01). Conclusions: A higher level of consistent contraceptive use among HIV+ women may indicate a firmer commitment to preventing unplanned pregnancies. Although different factors are associated with consistent contraceptive use among women at risk for HIV compared to HIV+ women, factors for both are potentially modifiable through intervention. Among women at high risk characterized by low self-efficacy, enhancing confidence in their ability to use contraception (e.g. through guided practice, role playing), and ensuring that HIV+ women have access to and support for drug treatment services may enhance the effectiveness of HIV prevention efforts. Contraception Behavior Contraceptive Agents Contraceptive Devices HIV Infections/PREVENTION & CONTROL *Substance-Related Disorders

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Information in this article was accurate in January 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.