Factors Associated with Hormonal and Intrauterine Contraceptive Use among HIV-Infected Men and Women in Lilongwe, Malawi: A Cross-Sectional Study

Background. Understanding the factors associated with the use of hormonal and intrauterine contraception among HIV-infected men and women may lead to interventions that can help reduce high unintended pregnancy rates. Materials and Methods. This study is a subanalysis of a cross-sectional survey of 289 women and 241 men who were sexually active and HIV-infected and were attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (PRs) to evaluate factors associated with hormonal and intrauterine contraceptive use for men and women in separate models. Results and Discussion. 39.8% of women and 33.2% of men (p=0.117) reported that they were using hormonal or intrauterine contraception at last intercourse. Having greater than 3 children was the only factor associated with hormonal and intrauterine contraceptive use among men. Among women, younger age, not wanting a pregnancy in 2 years, being with their partner for more than 4 years, and being able to make family planning decisions by themselves were associated with hormonal and intrauterine contraceptive use. Conclusions. The men and women in our study population differed in the factors associated with hormonal and intrauterine contraceptive use. Understanding these differences may help decrease unmet FP needs among HIV-infected men and women

Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi.

As access to antiretroviral therapy increases, more HIV-infected patients in sub-Saharan Africa may desire fertility. We conducted a cross-sectional study of reproductive health knowledge, attitudes and practices to identify factors associated with desired fertility among women and men receiving care at two large public HIV clinics in Lilongwe, Malawi. Research assistants administered questionnaires to participants. We performed descriptive, bivariable and multivariable analysis of factors related to desired fertility and of factors related to contraceptive non-use among participants who did not desire fertility. One-third of participants desired future children. Having a partner who desired fertility and having lower parity were associated with desiring children among both genders. For women, believing that pregnancy was unhealthy was associated with decreased fertility desire. Fifty-five percent of women and 69% of men who did not want children in the future reported using contraception at last intercourse. Increasing age, lower parity, and making the decision to use contraception herself were associated with contraceptive non-use among women who did not desire fertility. Having discussed family planning with his partner was associated with contraceptive use among men who did not desire fertility. Knowledge of these factors can guide reproductive health counseling and service provision

Unadjusted and adjusted prevalence ratios of HIV-positive women and men who desire children in the future and who received care at large, public HIV clinics in Lilongwe, Malawi.

<p>Unadjusted and adjusted prevalence ratios of HIV-positive women and men who desire children in the future and who received care at large, public HIV clinics in Lilongwe, Malawi.</p

Unadjusted and adjusted prevalence ratios of contraceptive non-use by HIV-positive women and men who do not desire fertility and who receive care at large, public HIV clinics in Lilongwe, Malawi.

<p>Unadjusted and adjusted prevalence ratios of contraceptive non-use by HIV-positive women and men who do not desire fertility and who receive care at large, public HIV clinics in Lilongwe, Malawi.</p

Characteristics of HIV-positive women and men who received care at large, public HIV clinics in Lilongwe, Malawi.

<p>Characteristics of HIV-positive women and men who received care at large, public HIV clinics in Lilongwe, Malawi.</p

Contraceptive use relied on at last intercourse among HIV-positive women and men who do not want to have children in the future and who are receiving care at large, public HIV clinics in Lilongwe, Malawi.

<p>Contraceptive use relied on at last intercourse among HIV-positive women and men who do not want to have children in the future and who are receiving care at large, public HIV clinics in Lilongwe, Malawi.</p