Kopp Dawn M, Tang Jennifer H, Stuart Gretchen S, Miller William C, O'Shea Michele S, Hosseinipour Mina C, Bonongwe Phylos, Mwale Mwawi, Rosenberg Nora E
UNC Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
UNC Department of Obstetrics & Gynecology, 101 Manning Drive, Chapel Hill, NC 27514, USA.
Infect Dis Obstet Gynecol. 2017;2017:1475813. doi: 10.1155/2017/1475813. Epub 2017 Jul 18.
Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended pregnancy and HIV infection. We evaluated the association of HIV status with dual method use in a cohort of postpartum women. Women completed baseline surveys in the postpartum ward and telephone surveys about contraceptive use 3, 6, and 12 months later. Nonpregnant women who completed at least one follow-up survey were eligible for this secondary analysis. Prevalence ratios were calculated using generalized estimating equations. Of the 511 sexually active women who completed a follow-up survey, condom use increased from 17.6% to 27.7% and nonbarrier contraceptive use increased from 73.8% to 87.6% from 3 to 12 months after delivery. Dual method use increased from 1.0% to 18.9% at 3 to 12 months after delivery. Dual method use was negligible and comparable between HIV-infected and HIV-uninfected women at 3 months but significantly higher among HIV-infected women at 6 months (APR = 3.9, 95% CI 2.2, 7.1) and 12 months (APR = 2.7, 95% CI 1.7, 4.3). Dual method use was low but largely driven by condom use among HIV-infected women at 6 and 12 months after delivery.
双重方法的使用，即避孕套与另一种有效避孕方法的结合使用，在意外怀孕和艾滋病毒感染率较高的环境中很重要。我们在一组产后妇女队列中评估了艾滋病毒感染状况与双重方法使用之间的关联。妇女在产后病房完成了基线调查，并在3个月、6个月和12个月后接受了关于避孕方法使用情况的电话调查。完成至少一次随访调查的非怀孕妇女符合此次二次分析的条件。使用广义估计方程计算患病率比值。在完成随访调查的511名性活跃妇女中，产后3个月至12个月期间，避孕套的使用率从17.6%增至27.7%，非屏障避孕方法的使用率从73.8%增至87.6%。产后3个月至12个月期间，双重方法的使用率从1.0%增至18.9%。在3个月时，艾滋病毒感染妇女和未感染艾滋病毒的妇女使用双重方法的情况可忽略不计且相当，但在6个月时（患病率比值比=3.9，95%置信区间2.2至7.1）和12个月时（患病率比值比=2.7，95%置信区间1.7至4.3），艾滋病毒感染妇女中双重方法的使用率显著更高。产后6个月和12个月时，艾滋病毒感染妇女双重方法的使用率较低，但主要由避孕套的使用推动。
