HIV & AIDS
Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study
Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended
pregnancy and HIV infection.We evaluated the association of HIV status with dualmethod use in a cohort of postpartumwomen.
Women completed baseline surveys in the postpartumward and telephone surveys about contraceptive use 3, 6, and 12months later.
Nonpregnant women who completed at least one follow-up survey were eligible for this secondary analysis. Prevalence ratios were
calculated using generalized estimating equations. Of the 511 sexually active women who completed a follow-up survey, condomuse
increased from 17.6% to 27.7% and nonbarrier contraceptive use increased from 73.8% to 87.6% from 3 to 12 months after delivery.
Dual method use increased from 1.0% to 18.9% at 3 to 12 months after delivery. Dual method use was negligible and comparable
between HIV-infected and HIV-uninfected women at 3 months but significantly higher among HIV-infected women at 6 months
(APR = 3.9, 95% CI 2.2, 7.1) and 12 months (APR = 2.7, 95% CI 1.7, 4.3). Dual method use was low but largely driven by condom use
among HIV-infected women at 6 and 12 months after delivery.
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