Contraceptive method and pregnancy incidence among African women in HIV-1 serodiscordant partnerships

"Contraceptive method and pregnancy incidence among African women in HIV-1 serodiscordant partnerships."; 2011.


Effective contraception reduces unintended pregnancies and is a central
strategy to reduce vertical HIV-1 transmission for HIV-1 infected women.
Methods: Among 2269 HIV-1 seropositive and 1085 seronegative women from 7
African countries who were members of HIV-1 serodiscordant heterosexual partner-
ships and who were participating in an HIV-1 prevention clinical trial, we assessed
pregnancy incidence according to contraceptive method using multivariate Andersen-
Gill analysis.
Results: Compared with women using no contraceptive method, pregnancy incidence
was significantly reduced among HIV-1 seropositive and seronegative women using
injectable contraception (adjusted hazard ratio (aHR) 0.24, p 1⁄4 0.001 and aHR 0.25,
p < 0.001, respectively). Oral contraceptives significantly reduced pregnancy risk only
among HIV-1 seropositive women (aHR 0.51, p 1⁄4 0.004) but not seronegative women
(aHR 0.64, p 1⁄4 0.3), and, for both seropositive and seronegative women, oral contra-
ceptive pill users were more likely to become pregnant than injectable contraceptive
users (aHR 2.22, p 1⁄4 0.01 for HIV-1 seropositive women and aHR 2.65, p 1⁄4 0.09 for
HIV-1 seronegative women). Condoms, when reported as being used as the primary
contraceptive method, marginally reduced pregnancy incidence (aHR 0.85, p 1⁄4 0.1 for
seropositive women and aHR 0.67, p 1⁄4 0.02 for seronegative women). There were no
pregnancies among women using intrauterine devices, implantable methods or who
had undergone surgical sterilization, although these methods were used relatively

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