Contraceptive Knowledge and Practice among HIV-Positive Women Receiving Antiretroviral Therapy at a District Hospital in KwaZulu-Natal

ABSTRACT

Objectives: To determine the knowledge and use of contraceptives by HIV-positive women attending an ART clinic. Design: Observational descriptive cross-sectional study. Setting and subjects: Many human immunodeficiency virus (HIV)-positive South African women fall pregnant each year while receiving antiretroviral therapy (ART). In 2010; 2 056 women of childbearing age attended the ART clinic at a district hospital south of Durban. Between October 2010 and June 2011; data were collected using a validated questionnaire from 400 women on their contraceptive knowledge and use. Women over 18 years of age who consented to participate; and who had been receiving ART for more than a month; were eligible for participation in the study. Outcome measures: Contraceptive knowledge and use. Results: All participants had received counselling on male condom use. The majority of HIV-positive women receiving ART preferred the male condom as their contraception of choice. Knowledge of male condoms was excellent; but only 66 of the study group used condoms; and just over 50 used a dual method of contraception (male condoms plus another contraceptive method). While 97 of participants were knowledgeable about injectable contraception; only 40 used the latter as a form of contraception. Ninety-two per cent of the participants reported recent sexual activity; 14 had fallen pregnant while receiving ART; and 64 planned on having a child in the future. Conclusion: The low use of dual contraception was a cause for concern. Recommendations include the integration of family planning services into HIV care at all ART sites. This should promote proper fertility management for women receiving ART