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. 2014 Sep;126(3):213-6.
doi: 10.1016/j.ijgo.2014.03.026. Epub 2014 May 13.

Medical eligibility, contraceptive choice, and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe, Malawi

Lisa B Haddad  1 , Caryl Feldacker  2 , Denise J Jamieson  3 , Hannock Tweya  4 , Carrie Cwiak  3 , Amy G Bryant  5 , Mina C Hosseinipour  6 , Thomas Chaweza  4 , Linly Mlundira  4 , Fanny Kachale  7 , Gretchen S Stuart  5 , Irving Hoffman  5 , Sam Phiri  4
Affiliations

Medical eligibility, contraceptive choice, and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe, Malawi

Lisa B Haddad et al. Int J Gynaecol Obstet. 2014 Sep.

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.

Keywords: Antiretroviral therapy; Contraception; HIV; Intrauterine contraception; Intrauterine device; Malawi; Medical eligibility.

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Conflict of interest statement

Conflict of interest

The authors have no conflicts of interest.

References

    1. UNAIDS, UNFPA. [Accessed March 17, 2014];Making condoms work for HIV prevention. http://data.unaids.org/publications/irc-pub06/jc941-cuttingedge_en.pdf. Published 2004.
    1. World Health Organization (WHO) Department of Reproductive Health and Research, Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP) Knowledge for health project. Family planning: a global handbook for providers (2011 update) Baltimore, MD; Geneva, Switzerland: CCP and WHO; 2011.
    1. Wall KM, Vwalika B, Haddad L, Khu NH, Vwalika C, Kilembe W, et al. Impact of long-term contraceptive promotion on incident pregnancy: a randomized controlled trial among HIV-positive couples in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2013;63(1):86–95. - PMC - PubMed
    1. World Health Organization. [Accessed March 17, 2014];Medical Eligibility Criteria for Contraceptive Use. (4). http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf. Published 2010.
    1. Sinei SK, Morrison CS, Sekadde-Kigondu C, Allen M, Kokonya D. Complications of use of intrauterine devices among HIV-1-infected women. Lancet. 1998;351(9111):1238–41. - PubMed

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