Dual contraception adherence among HIV-infected women

• Published in: Revista Brasileira de ginecologia e obstetrícia 2015-10, Vol.37 (10), p.486-491
• Main Authors: Brandão, Karina de Sá Adami Gonçalves, Lima, Bruno Gil de Carvalho, Travassos, Ana Gabriela Álvares, de Brito, Fabielle de Oliveira Rocha, de Souza, Eveline Xavier Pereira, Haguihara, Tatiana, da Silva, Carlos Alberto Lima
• Format: Article
• Language: Portuguese
• Subjects: Adolescent; Adult; Condoms; Contraceptive Agents, Female; Cross-Sectional Studies; Female; HIV Infections - prevention & control; HIV Infections - transmission; Humans; Medroxyprogesterone Acetate; Middle Aged; Patient Compliance - statistics & numerical data; Young Adult
• ISSN: 1806-9339
• DOI: 10.1590/SO100-720320150005347

To determine adherence to dual contraception using depot-medroxyprogesterone acetate (DMPA) and condom among HIV-infected women. A cross-sectional study carried out from December 2013 to September 2014 at a local reference center, with application of questionnaire elaborated after Delphi panel and content validation to 114 HIV(+) women aged 15 to 49 years, using DMPA plus condom for contraception. Mean age was 33.2 ± 7.2 years, mean time since HIV detection was 8.1 ± 5.2 years, mean time of antiretroviral use was 6.8 ± 5 years and mean CD4 cells/mm3 count was 737.6 ± 341.1. Sexual HIV acquisition was reported by 98.2% (112/114), antiretroviral use by 85.9% (98/114), and 77.7% (84/114) had a CD4>500/mm3 count. Having a single sex partner was reported by 78.9% (90/114), with HIV serodiscordance in 41.2% (47/114) of couples, 21.9% did not know the serological status of their partner and in 37.7% of cases (43/114) the partner was unaware of the HIV(+) status of the woman. The last pregnancy was unplanned in 71.9% of cases (82/114) and 14.9% of the women had become pregnant the year before, with pregnancy being unplanned in 70.5% (12/17) of cases. Current use of DMPA was reported by 64.9% (74/114), with genital bleeding in 48.2% (55/114) and weight gain in 67.5% (77/114). Use of a male condom was reported by 62.2% of the subjects (71/114). Three reported that they always used a female condom and ten that they eventually used it. Unprotected vaginal sex was reported by 37.7% (43/114) and unprotected anal intercourse was reported by 32.4% (37/114). Partner resistance to use a condom occurred in 30.7% of cases (35/114). Dual contraception using DMPA with condom was reported by 42.9% (49/114). A partner who resisted wearing a condom was associated with poor adhesion (PR=0.3; 95%CI 0.2-0.7; p