The Year-Long Effect of HlV-Positive Test Results on Pregnancy Intentions, Contraceptive Use, and Pregnancy Incidence Among Malawian Women

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 47; no. 4; pp. 477 - 483
• Main Authors: Hoffman, L F, Martinson, FEA, Powers, KA, Chilongozi, DA, Msiska, ED, Kachipapa, E I, Mphande, C D, Hosseinipour, M C, Chanza, H C, Stephenson, R, Tsui, A O
• Format: Journal Article
• Language: English
• Published: 01-04-2008
• Subjects: Malawi
• ISSN: 1525-4135

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.