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. 2007 Jan;34(1):25-9.
doi: 10.1097/01.olq.0000218880.88179.36.

High uptake of postpartum hormonal contraception among HIV-1-seropositive women in Kenya

Jennifer Balkus  1 , Rose Bosire, Grace John-Stewart, Dorothy Mbori-Ngacha, Melissa A Schiff, Dalton Wamalwa, Christine Gichuhi, Elizabeth Obimbo, Grace Wariua, Carey Farquhar
Affiliations

High uptake of postpartum hormonal contraception among HIV-1-seropositive women in Kenya

Jennifer Balkus et al. Sex Transm Dis. 2007 Jan.

Abstract

Objectives: The objectives of this study were to determine patterns of contraceptive utilization among sexually active HIV-1-seropositive women postpartum and to identify correlates of hormonal contraception uptake.

Goal: The goal of this study was to improve delivery of family planning services to HIV-1-infected women in resource-limited settings.

Study design: HIV-1-infected pregnant women were followed prospectively in a perinatal HIV-1 transmission study. Participants were referred to local clinics for contraceptive counseling and management.

Results: Among 319 HIV-1-infected women, median time to sexual activity postpartum was 2 months and 231 (72%) women used hormonal contraception for at least 2 months during follow-up, initiating use at approximately 3 months postpartum (range, 1-11 months). Overall, 101 (44%) used DMPA, 71 (31%) oral contraception, and 59 (25%) switched methods during follow-up. Partner notification, infant mortality, and condom use were similar between those using and not using contraception.

Conclusions: Using existing the healthcare infrastructure, it is possible to achieve high levels of postpartum hormonal contraceptive utilization among HIV-1-seropositive women.

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Figures

Fig. 1
Fig. 1
Enrollment flow chart. 1Fifty-three (10%) women were lost to follow-up before delivery or experienced an infant death in the month after delivery. 2There were 12 (3%) maternal deaths and 35 (10%) women were lost to follow-up. 3Fourteen (4%) women used contraception for only 1 month and were excluded from the analysis.
Fig. 2
Fig. 2
Oral and injectable postpartum contraceptive use among sexually active HIV-1-infected women by month of follow-up (N = 319).
Fig. 3
Fig. 3
Postpartum hormonal contraceptive use and sexual activity by month of follow-up (N = 319).
See this image and copyright information in PMC

References

    1. World Health Organization. Hormonal Contraception and HIV: Science and Policy. Africa Regional Meeting; Nairobi. 2005.
    1. Kenya Demographic and Health Survey. 2003 Available at: http://www.cbs.go.ke.
    1. World Health Organization. Medical Eligibility Criteria for Contraceptive Use. Geneva: World Health Organization; 2004.
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    1. Desgrees-du-Lou A, Msellati P, Viho I, et al. Contraceptive use, protected sexual intercourse and incidence of pregnancies among African HIV-infected women. DITRAME ANRS 049 Project, Abidjan 1995–2000. Int J STD AIDS. 2002;13:462–468. - PubMed

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