Trends and correlates of hormonal contraceptive use among HIV-infected women in Rakai, Uganda, 1994-2006

Background: Little is known about what factors correlate with hormonal contraceptive (HC) use in HIV-infected women in sub-Saharan Africa. Methods: We assessed the trends in HC use among HIV-infected women in Rakai, Uganda; determined factors associated with HC use and considered whether those factors changed over time. Results: HC use among HIV-infected women in Rakai increased from 5.7% in 1994 to 19.2% in 2006, but nearly half of all pregnancies in this population were unintended. Variables associated with increased HC use included higher education, socioeconomic status, parity, sexual frequency, being currently married or in a relationship, discussion of family planning with a partner and receipt of HIV results. Variables negatively associated with HC use included symptoms suggestive of opportunistic infections, having no sex partner in the past year, condom use, breastfeeding and older age. Most associations remained stable over time. Conclusion: Although contraceptive use by HIV-infected women has increased three-fold in this rural population, unintended pregnancies persist, placing women and their children at risk of adverse consequences. (C) 2011 Elsevier Inc. All rights reserved.