Neglect of attention to reproductive health in women with HIV infection: contraceptive use and unintended pregnancies in the Swiss HIV Cohort Study

• Published in: HIV medicine 2018-05, Vol.19 (5), p.339-346
• Main Authors: Aebi‐Popp, K, Mercanti, V, Voide, C, Nemeth, J, Cusini, A, Jakopp, B, Nicca, D, Rasi, M, Bruno, A, Calmy, A, Martinez de Tejada, B, Aubert, V, Battegay, M, Bernasconi, E, Böni, J, Braun, L, Bucher, C, Cavassini, M, Ciuffi, A, Dollenmaier, G, Egger, M, Elzi, L, Fehr, J, Fellay, J, Furrer, H, Fux, A, Günthard, F, Haerry, D, Hasse, B, Hirsch, H, Hoffmann, M, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, D, Kovari, H, Ledergerber, B, Martinetti, G, Marzolini, C, Metzner, J, Müller, N, Pantaleo, G, Paioni, P, Rauch, A, Rudin, C, Scherrer, U, Schmid, P, Speck, R, Stöckle, M, Tarr, P, Trkola, A, Vernazza, P, Wandeler, G, Weber, R, Yerly, S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antiretroviral agents; Antiretroviral therapy; Birth control; Cohort analysis; Condoms; Contraception; Contraceptive Agents - therapeutic use; Contraceptives; Cross-Sectional Studies; Drug Utilization - statistics & numerical data; Family planning; Family Planning Services - methods; Family Planning Services - organization & administration; Female; Health care; Health Services Research; HIV; HIV infection; HIV Infections; Human immunodeficiency virus; Humans; Infections; Intrauterine devices; IUD; Methods; Middle Aged; Pregnancy; Pregnancy, Unplanned; Reproductive health; Sexually transmitted diseases; STD; Surveys and Questionnaires; Switzerland; unintended pregnancy; women; Young Adult
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.12582

Objectives Women with HIV infection are mainly of reproductive age and need safe, effective and affordable contraception to avoid unintended pregnancies. The aim of this study was to evaluate contraceptive use and unintended pregnancies in this population in Switzerland. Methods A self‐report anonymous questionnaire on contraceptive methods, adherence to them, and unintended pregnancies was completed by women included in the Swiss HIV Cohort Study (SHCS) between November 2013 and June 2014. Sociodemographic characteristics and information related to combined antiretroviral therapy and HIV disease status were obtained from the SHCS database. Results Of 462 women included, 164 (35.5%) reported not using any contraception. Among these, 65 (39.6%) reported being sexually active, although 29 (44.6%) were not planning a pregnancy. Of 298 women using contraception, the following methods were reported: condoms, 219 (73.5%); oral hormonal contraception, 32 (10.7%); and intrauterine devices, 28 (9.4%). Among all women on contraception, 32 (10.7%) reported using more than one contraceptive method and 48 (16%) had an unintended pregnancy while on contraception (18, condoms; 16, oral contraception; four, other methods). Of these, 68.1% terminated the pregnancy and almost half (43.7%) continued using the same contraceptive method after the event. Conclusions Family planning needs in HIV‐positive women are not fully addressed because male condoms remained the predominant reported contraceptive method, with a high rate of unintended pregnancies. It is of utmost importance to provide effective contraception such as long‐acting reversible contraceptives for women living with HIV.