Effective contraceptive use is crucial for HIV-positive women to prevent unintended pregnancy. We aim to explore the factors influencing contraceptive method choice among HIV-positive women in the US.METHODS:
HIV-positive women age 18-45 completed a cross-sectional survey and were eligible if they reported recent sexual activity and had not been sterilized. Chi-square tests and multivariable logistic regression were used to assess factors associated with Tier 1/2 efficacy methods (IUDs, implant, ring, pill, and Depo) within the past month compared to Tier 3 (condom, withdrawal) or no method use.RESULTS:
Of 105 eligible participants, 31(26%) reported usage of efficacy Tier 1/2 methods. Significant factors associated with higher efficacy method use were younger age (unadjusted prevalence odds ratio per year, cPOR .86 95% CI .80-.91), age over 19 at time of HIV diagnosis (cPOR .28 95% CI .08-.57), higher recent CD4 count (>200 cells/µL, cPOR 2.5, 95% CI 1.1-6.0), HIV+ status during prior pregnancy (cPOR 6.3 95% CI 1.4-29.4), and belief that ‘it’s okay to take birth control that stops your period from coming’ (cPOR 2.8 95% CI 1.1-7.1). While knowledge did not differ significantly across efficacy tiers, the study population revealed a general lack of knowledge regarding contraceptive methods and a notable lack of self-efficacy regarding these choices.CONCLUSION:
The women in this study who chose higher efficacy methods were clinically healthier. This may reflect more attention to care, patient compliance, or more time during HIV visits to address contraception. Improved knowledge about contraceptive methods is needed among HIV+ women.