Haddad Lisa B, Feldacker Caryl, Jamieson Denise J, Tweya Hannock, Cwiak Carrie, Chaweza Thomas, Mlundira Linly, Chiwoko Jane, Samala Bernadette, Kachale Fanny, Bryant Amy G, Hosseinipour Mina C, Stuart Gretchen S, Hoffman Irving, Phiri Sam
Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, Georgia, United States of America.
The Lighthouse Trust, Lilongwe, Malawi; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, Washington, United States of America.
PLoS One. 2015 Mar 26;10(3):e0121039. doi: 10.1371/journal.pone.0121039. eCollection 2015.
Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic.
200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.
Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.
High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.
将计划生育纳入艾滋病护理的项目必须认识到服务对象当前的行为习惯和需求，以便合理确定干预措施的目标人群并进行调整。我们试图评估在一家抗逆转录病毒治疗（ART）诊所寻求计划生育服务的一群感染艾滋病病毒的女性的生育意愿、意外怀孕情况、避孕措施和避孕套使用情况。
2010年8月至12月期间，在马拉维利隆圭的一家艾滋病/抗逆转录病毒治疗诊所——灯塔诊所，200名女性在参与一项前瞻性避孕研究登记时完成了一份由访谈员填写的问卷。
大多数女性（95%）不希望未来怀孕。此前报告的意外怀孕率很高（69%的怀孕是意外怀孕，61%对最后一次怀孕的时间不满意）。避孕套的使用情况不稳定，即使在夫妻双方艾滋病病毒感染状况不一致的情况下也是如此，不使用避孕套往往归因于伴侣的拒绝。高等教育程度、年龄较大、低生育次数以及有一个艾滋病病毒阴性的伴侣是与持续使用避孕套相关的因素。
这些女性中意外怀孕率很高，这突出表明需要将计划生育、性传播感染（STI）预防和艾滋病服务结合起来。必须改善避孕措施的获取和使用情况，包括避孕套的使用，尤其要努力争取伴侣的支持。在持续进行抗逆转录病毒治疗的过程中，必须继续强化关于使用避孕套结合更有效的现代避孕方法对预防感染和怀孕的重要性的信息。
