*Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya; †National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya; and ‡Global Health Sciences, University of California, San Francisco, San Francisco, CA.
J Acquir Immune Defic Syndr. 2014 May 1;66 Suppl 1(Suppl 1):S75-81. doi: 10.1097/QAI.0000000000000107.
Prevention of unplanned pregnancies is a critical element in the prevention of mother-to-child transmission of HIV infection, but its potential has not been fully realized. We assessed the utilization of family planning (FP) and fertility desires among women of reproductive age by HIV status.
We selected a nationally representative sample of households using a stratified 2-stage cluster design and surveyed women aged 15-49 years. We administered questionnaires and examined predictors of current use of FP and desire for children among sexually active women with known HIV infection and women who were HIV uninfected.
Of 3583 respondents, 68.2% were currently using FP, and 57.7% did not desire children in the future. Among women who did not desire children in the future, 70.9% reported that they were using FP, including 68.7% of women with known HIV infection and 71.0% of women who were HIV uninfected. Women with known HIV infection had similar odds of using FP as women with no HIV infection (odds ratio, 1.12; 95% confidence interval: 0.81 to 1.54). Women with no HIV infection had significantly higher adjusted odds of desiring future children (adjusted OR, 2.27; 95% confidence interval: 1.31 to 3.93) than women with known HIV infection.
There is unmet need for FP for HIV-infected women, underscoring a gap in the national prevention of mother-to-child transmission of HIV strategy. Efforts to empower HIV-infected women to prevent unintended pregnancies should lead to expanded access to contraceptive methods and take into account women's reproductive intentions.
预防非意愿妊娠是预防母婴传播艾滋病毒感染的关键环节，但这一潜力尚未得到充分发挥。我们评估了不同艾滋病毒感染状况的育龄妇女对计划生育（FP）的利用情况和生育愿望。
我们采用分层两阶段聚类设计选择了一个具有全国代表性的家庭样本，并对 15-49 岁的女性进行了调查。我们对已知艾滋病毒感染和未感染艾滋病毒的性活跃女性进行了问卷调查，并检查了目前使用 FP 和未来生育愿望的预测因素。
在 3583 名受访者中，68.2%的人目前正在使用 FP，57.7%的人未来不想要孩子。在未来不想要孩子的女性中，70.9%的人报告正在使用 FP，其中 68.7%的已知艾滋病毒感染女性和 71.0%的未感染艾滋病毒女性。已知艾滋病毒感染的女性使用 FP 的可能性与未感染艾滋病毒的女性相似（比值比，1.12；95%置信区间：0.81 至 1.54）。未感染艾滋病毒的女性未来生育愿望的调整后比值比（adjusted OR）显著高于已知艾滋病毒感染的女性（调整后 OR，2.27；95%置信区间：1.31 至 3.93）。
艾滋病毒感染女性对 FP 的需求未得到满足，这突显了国家预防母婴传播艾滋病毒战略中的一个差距。为了增强艾滋病毒感染女性预防非意愿妊娠的能力，应该扩大获得避孕方法的机会，并考虑到女性的生育意愿。
