The year-long effect of HIV-positive test results on pregnancy intentions, contraceptive use, and pregnancy incidence among Malawian women

Irving F. Hoffman, Francis E.A. Martinson, Kimberly A. Powers, David A. Chilongozi, Emmie D. Msiska, Emma I. Kachipapa, Chimwemwe D. Mphande, Mina C. Hosseinipour, Harriet C. Chanza, Rob Stephenson, Amy O. Tsui

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: To estimate the effect of receiving HIV-positive test results on intentions to have future children and on contraceptive use and to assess the association between pregnancy intentions and pregnancy incidence among HIV-positive women in Malawi. METHODS: Women of unknown HIV status completed a questionnaire about pregnancy intentions and contraceptive use and then received HIV voluntary counseling and testing (VCT). Women who were HIV-positive and not pregnant were enrolled and followed for 1 year while receiving HIV care and access to family planning (FP) services. RESULTS: Before receiving their HIV test results, 33% of women reported a desire to have future children; this declined to 15% 1 week later (P < 0.0001) and remained constant throughout follow-up. Contraceptive use increased from 38% before HIV testing to 52% 1 week later (P < 0.0001) and then decreased to 46% by 12 months. The pregnancy incidence among women not reporting a desire to have future children after VCT was less than half of the incidence among women reporting this desire. CONCLUSIONS: With knowledge of their HIV-positive status, women were less likely to desire future pregnancies. Pregnancy incidence was lower among women not desiring future children. Integration of VCT, FP, and HIV care could prevent mother-to-child HIV transmission.

Original languageEnglish (US)
Pages (from-to)477-483
Number of pages7
JournalJournal of acquired immune deficiency syndromes
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2008

Keywords

  • Contraceptives
  • HIV testing
  • Malawi
  • Pregnancy incidence
  • Pregnancy intentions

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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