Medical eligibility,contraceptive choice,and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe,Malawi |
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Authors: | Lisa B. Haddad Caryl Feldacker Denise J. Jamieson Hannock Tweya Carrie Cwiak Amy G. Bryant Mina C. Hosseinipour Thomas Chaweza Linly Mlundira Fanny Kachale Gretchen S. Stuart Irving Hoffman Sam Phiri |
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Affiliation: | 1. Emory University, Department of Gynecology and Obstetrics, Atlanta, USA;2. The Lighthouse Trust, Lilongwe, Malawi;3. International Training and Education Center for Health (I-TECH), University of Washington, Seattle, USA;4. University of North Carolina-Chapel Hill, Chapel Hill, USA;5. University of North Carolina Project-Malawi, Lilongwe, Malawi;6. Reproductive Health Services, Ministry of Health, Lilongwe, Malawi |
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Abstract: | ObjectiveTo 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).MethodsAll 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.ResultsThe 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.ConclusionMost 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. |
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Keywords: | Antiretroviral therapy Contraception HIV Intrauterine contraception Intrauterine device Malawi Medical eligibility |
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