Despite risks of HIV transmission to infants born of the HIV positive
women, contraceptive use is uncommon among women in HIV discordant
partnerships. The aim of this study was to determine the factors
associated with contraceptive use in a clinical trial cohort of HIV
serodiscordant couples based in Thika and Eldoret, Kenya. Data were
analyzed from 481 HIV discordant couples enrolled in the Partners in
Prevention HSV/HIV Transmission Study at the Thika and Eldoret sites.
The primary study outcome was self-reported use of contraception other
than condoms. Using a marginal longitudinal logistic model based on
generalized estimating equations (GEE) approach we assessed the
association of various demographic and behavioral factors with
contraceptive use. At baseline the prevalence of non barrier
contraceptive use among HIV positive and negative women was 24.3% and
25.7%, respectively. At month 12 of follow-up, the prevalence of
contraceptive use was 44.4% among the HIV positive and 26% among the
HIV negative women while at month 24, the prevalence of contraceptive
use was 38.6% among the HIV positive and 18.2% among the HIV negative
women. HIV positive women were more likely to report using
contraception than HIV negative women (odds ratio (OR) 1.61 95%
confidence interval (CI) 1.04-2.47). Additionally, being married (OR
2.4, 95% CI 1.2-5.0), attending Thika site clinic (OR 6.1, 95% CI
4.2-9.0), and having two or more children (OR 1.9, 95% CI 1.3-2.8) were
significantly associated with use of non barrier contraceptives. Future
programs should focus on interventions to increase contraceptive use
among HIV serodiscordant couples, with a special emphasis on HIV
negative women, unmarried women and women with few children