感染艾滋病毒和未感染艾滋病毒的非洲妇女有效计划生育方法的使用情况及性行为频率

Use of effective family planning methods and frequency of sex among HIV-infected and HIV-uninfected African women.

作者信息

Aizire Jim, Dadabhai Sufia, Taulo Frank, Makanani Bonus, Gadama Luis, Sun Jin, Tsui Amy, Taha Taha E

机构信息

1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA.

2Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Blantyre, Malawi.

出版信息

Contracept Reprod Med. 2018 Jul 9;3:10. doi: 10.1186/s40834-018-0063-z. eCollection 2018.

DOI:10.1186/s40834-018-0063-z

PMID:30002871

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6036664/

Abstract

BACKGROUND

Frequency of sex, contraceptive use and HIV infection are key determinants of fertility. Use of an effective family planning (EFP) method (injectable, oral, intra-uterine contraceptive device (IUCD), or Norplant) potentially eliminates women's concerns of unintended pregnancy. We report the association between EFP and frequency of sex among HIV-infected and HIV-uninfected non-pregnant African women.

METHODS

Prospective fertility intentions study nested within a phase 3 randomized double-masked placebo-controlled trial (2003-2005) to treat genital tract infections in HIV-infected and HIV-uninfected non-pregnant women. Enrollment of study participants was stratified by HIV infection status. Data on demographics, family planning and sexual history were obtained at baseline and at 3, 6, 9 and 12 months. Chi square and Wilcoxon Rank-Sum tests were used to compare categorical and continuous variables, respectively. Generalized Estimating Equations method was used to estimate relative risk (RR) of frequent sex (≥ 2 acts/week) among users of different EFP methods (injectable, oral, implant or intra-uterine contraceptive device).

RESULTS

After adjusting for age, current health status, and fertility intentions, EFP use was significantly associated with frequent sex among HIV-infected women (RR 1.32; 95% Confidence Interval [CI] 1.14-1.52); this association was not statistically significant among HIV-uninfected women (RR 1.10; 95% CI 0.96-1.24). Fertility intentions among HIV-infected, and education among HIV-uninfected womenwere independent predictors of sex frequency.

CONCLUSION

These data suggest that the association between EFP use and frequency of sex among women varies by HIV infection status. Service-delivery of diverse EFP methods should be integrated within HIV counseling, testing and treatment facilities.

TRIAL REGISTRATION

Registration number NCT00140764 under the clinicaltrials.gov, first Posted: September 1, 2005, last Update Posted: August 10, 2011.

摘要

背景

性行为频率、避孕措施使用情况及感染艾滋病毒情况是生育能力的关键决定因素。采用有效的计划生育（EFP）方法（注射用、口服、宫内节育器（IUCD）或皮下埋植剂）有可能消除女性对意外怀孕的担忧。我们报告了感染艾滋病毒和未感染艾滋病毒的未怀孕非洲女性中EFP与性行为频率之间的关联。

方法

前瞻性生育意愿研究嵌套于一项3期随机双盲安慰剂对照试验（2003 - 2005年）中，该试验旨在治疗感染艾滋病毒和未感染艾滋病毒的未怀孕女性的生殖道感染。研究参与者的入组按艾滋病毒感染状况分层。在基线以及第3、6、9和12个月获取有关人口统计学、计划生育和性史的数据。分别使用卡方检验和威尔科克森秩和检验来比较分类变量和连续变量。采用广义估计方程法估计不同EFP方法（注射用、口服、植入剂或宫内节育器）使用者中频繁性行为（≥2次/周）的相对风险（RR）。

结果

在对年龄、当前健康状况和生育意愿进行调整后，使用EFP与感染艾滋病毒女性的频繁性行为显著相关（RR 1.32；95%置信区间[CI] 1.14 - 1.52）；在未感染艾滋病毒的女性中，这种关联无统计学意义（RR 1.10；95% CI 0.96 - 1.24）。感染艾滋病毒女性的生育意愿以及未感染艾滋病毒女性的受教育程度是性行为频率的独立预测因素。