AEGiS-14IAC: Family planning and condom use among postpartum women with HIV-1 in the US.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Family planning and condom use among postpartum women with HIV-1 in the US.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrD1235)

Wilson T, Walter E, Koenig L, Ickovics J, Fernandez I
State University of New York, Downstate Medical Center, Brooklyn NY, United States

BACKGROUND: Study objectives were to describe pregnancy intentions and correlates of condom use among postpartum women with HIV infection.

METHODS: Between 1996-1998, 334 HIV-infected women were recruited from prenatal clinics in the US; FL, NY, NC, CT. Of these, 257 (77%) completed two interviews (in the prenatal period and at 6 months postpartum) assessing psychosocial, behavioral, and obstetric factors.

RESULTS: Over half (58%) of women were diagnosed with HIV prior to the pregnancy; 9.3% had previously given birth to a child with HIV; 3% did so as a result of the index pregnancy. At 6 months postpartum, 72% had vaginal sex; 2% were pregnant. Of those not pregnant, 10% reported that they might become pregnant in the next 6 months; 81% said they would be upset if this happened. Forty-two percent agreed that "it is unfair to a baby for a woman with HIV to get pregnant", 30% agreed that "a woman should not get pregnant if she has HIV". In the postpartum period, 76% reported a main sexual partner; of those who had vaginal sex, 61% always used condoms. Of those using condoms, 15% used them to prevent pregnancy, 20% to prevent HIV/STD, and the remainder for both reasons. Seven percent used crack or heroin use in the postpartum period. In multivariate logistic analysis, consistent condom use was associated with: history of a child with HIV, OR = 7.0, 95% CI = 1.4-33.3; no drug use, OR = 4.2, 95% CI = 1.1-15.9; having a main partner, OR = 4.0, 95% CI = 1.1-14.9; believing that women with HIV should not get pregnant, OR = 2.6, 95% CI = 1.0-6.6; and negative feelings about becoming pregnant, OR = 2.4, 95% CI = 1.0-5.9.

CONCLUSIONS: Women with HIV who have recently delivered are at risk for closely spaced pregnancies and unprotected intercourse. Those who have not had an infected child, use drugs, or lack a main partner are at greater risk for unprotected sex. Thus, the postpartum care setting may provide an important opportunity to provide safer sex counseling.

Keywords: AEGIS, HIV-1, Family Planning Services, Safe Sex, HIV Infections, Condoms, Puerperium, HIV Seropositivity, Counseling, Sex Counseling, Human, Female, Infant, Child, Pregnancy

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