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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Successful increase in contraceptive uptake among Kenyan HIV-1-serodiscordant couples enrolled in an HIV-1 prevention trial
AIDS, Volume 23, No. SUPPL. 1, Year 2009
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Description
OBJECTIVE: To evaluate a multipronged approach to promote dual contraceptive use by women within heterosexual HIV-1-serodiscordant partnerships. METHODS: For 213 HIV-1-serodiscordant couples in Thika, Kenya, participating in an HIV-1 prevention clinical trial, contraceptive promotion was initiated through a multipronged intervention that included staff training, couples family planning sessions, and free provision of hormonal contraception on-site. Contraceptive use and pregnancy incidence were compared between two time periods (before versus after June 2007, when the intervention was initiated) and between Thika and other Kenyan trial sites (Eldoret, Kisumu, and Nairobi). Generalized estimating equations and Andersen-Gill proportional hazards modeling were used. RESULTS: Nonbarrier contraceptive use increased after implementation of the intervention: from 31.5 to 64.7% of visits among HIV-1-seropositive women [odds ratio 4.0, 95% confidence interval (CI) 3.0-5.3] and from 28.6 to 46.7% of visits among HIV-1-seronegative women (odds ratio 2.2, 95% CI 1.4-3.5). In comparison, at the other Kenyan sites, where the intervention was not implemented, contraceptive use changed minimally, from 15.6 to 22.3% of visits for HIV-1-seropositive women and from 13.6 to 12.7% among HIV-1-seronegative women. Self-reported condom use remained high during follow-up. Pregnancy incidence at the Thika was significantly lower after compared with before June 2007 (hazard ratio 0.2, 95% CI 0.1-0.6) and was approximately half that at other Kenyan sites during the intervention period (hazard ratio 0.5, 95% CI 0.3-0.8). CONCLUSION: A multipronged family planning intervention can lead to high nonbarrier contraceptive uptake and reduced pregnancy incidence among women in HIV-1-serodiscordant partnerships. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Ngure, Kenneth K.
Kenya, Nairobi
Kenyatta National Hospital
Heffron, Renee A.
Unknown Affiliation
Mugo, Nelly Rwamba
Kenya, Nairobi
Kenyatta National Hospital
Irungu, Elizabeth M.
Kenya, Nairobi
Kenyatta National Hospital
Celum, Connie L.
United States, Seattle
University of Washington
Baeten, Jared M.
United States, Seattle
University of Washington
Statistics
Citations: 47
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1097/01.aids.0000363781.50580.03
e-ISSN:
14735571
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Case-Control Study
Study Locations
Kenya
Participants Gender
Female