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1996-03-09
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Document 0302
DOCN M9650302
TI A family planning intervention to reduce vertical transmission of HIV in
Rwanda.
DT 9605
AU King R; Estey J; Allen S; Kegeles S; Wolf W; Valentine C; Serufilira A;
Department of Epidemiology and Biostatistics, UCSF, USA.
SO AIDS. 1995 Jul;9 Suppl 1:S45-51. Unique Identifier : AIDSLINE
MED/96085743
AB OBJECTIVES: Since contraception is an effective way of preventing the
vertical transmission of HIV, we evaluated the impact of a family
planning intervention on hormonal contraceptive use and incident
pregnancy in a group of HIV-positive and HIV-negative urban Rwandan
women. SUBJECTS AND METHODS: In a longitudinal cohort study, 502 women
who were not pregnant or infertile and who had been previously HIV
tested and counseled viewed an informational video about hormonal
contraception followed by a facilitated discussion. They were given
access to oral or injectable hormonal contraception and Norplant at the
research clinic; those who used these methods were seen every 3 months.
RESULTS: Of the 330 HIV-positive and 172 HIV-negative women who
underwent the intervention, 120 either became new hormonal method users
(n = 40), continued their previous use of a hormonal method (n = 64), or
switched to another hormonal method (n = 16) following the intervention.
There was a shift to use of longer lasting hormonal methods, and the
annualized attrition rate was < 15%, compared to > 50% prior to the
intervention. Rates of oral and injectable contraceptive use were
similar among HIV-positive and HIV-negative women. Nine per cent of
HIV-positive women became pregnant in the year after the intervention
compared to 22% in a prior 12 month period when contraceptives were not
provided at the study site. The corresponding proportions for
HIV-negative women were 20% after the intervention versus 30% before the
intervention. CONCLUSIONS: Access to and information about hormonal
contraceptives resulted in increased use and reduced attrition among
both HIV-positive and HIV-negative women in this study. The reduction in
incident pregnancy was greatest among HIV-positive women, suggesting
that factors other than access to hormonal contraceptives may have
influenced fertility outcomes. Knowledge of HIV serostatus may have an
important influence on family planning decisions.
DE Adolescence Adult Contraception Behavior *Developing Countries
Disease Transmission, Vertical Family Planning Female Follow-Up
Studies Health Education Health Services Accessibility Human HIV
Infections/*PREVENTION & CONTROL/TRANSMISSION Infant, Newborn
Knowledge, Attitudes, Practice Pregnancy Pregnancy Complications,
Infectious/*PREVENTION & CONTROL Program Evaluation Rwanda Support,
Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Urban Population JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).