N'guessan Edouard, Gbeli Franck, Dia Jean Marc, Guie Privat
Service de Gynéco-obstétrique, CHU de Treichville, Abidjan, Côte d'Ivoire.
Pan Afr Med J. 2019 Jun 3;33:79. doi: 10.11604/pamj.2019.33.79.16435. eCollection 2019.
Family planning is a high impact strategy to reduce maternal mortality and to prevent mother-to-child transmission of HIV. This study aims to describe contraceptive practices of HIV-infected women followed upon an ambulatory basis at the Treichville University Hospital.
We conducted a cross-sectional descriptive multicenter survey of people living with HIV in the ambulatory care units of the Treichville University Hospital from 1 April to 30 June 2016. During this period, all HIV positive patients of childbearing age attending the Department of Obstetrics and Gynecology, the Pneumophtisiology Department, the Department of Dermatovenereology and the Department of internal medicine were invited to complete a standardized questionnaire on the sociodemographic, medical characteristics and the contraceptive practices.
In total, 283 women agreed to participate in the study, their median age was 36 years with an average parity of 1.7. Patients were nulliparous in only 22.3% of cases and lived with a partner in 54.8% of cases. They had no child with the current partner in 68.2% of cases. The partner was informed about their HIV status in 51.6% of cases. They were under antiretroviral treatment in 92.9% of cases with a median mean CD4 of 382 cells/mL. The majority of patients (62.9%) declared that they were using a modern contraceptive method. They mainly used progestin injectable (45.5%) and contraceptive implant (32.6%). The practice of dual protection was reported by only 17.4% of them. Secondary and higher education (OR=2.23 [1,35-3,69], p=0.01), multiparity (OR=1.84 [1,11-3,06], p=0.002) and revelation of HIV positive status to the partner (OR=1.86 [1,14-3,03], p<0.01) were factors significantly associated with the use of contraception.
Based on our experience, contraceptive practices in women infected with HIV are generally discouraging. It is essential to develop strategies to improve the integration of family planning into the management of HIV-infected women.
计划生育是降低孕产妇死亡率和预防母婴传播艾滋病毒的一项具有重大影响的战略。本研究旨在描述在特雷奇维尔大学医院接受门诊治疗的感染艾滋病毒妇女的避孕措施。
我们于2016年4月1日至6月30日在特雷奇维尔大学医院的门诊护理单元对艾滋病毒感染者进行了一项横断面描述性多中心调查。在此期间，邀请所有到妇产科、肺病科、皮肤性病科和内科就诊的育龄艾滋病毒阳性患者填写一份关于社会人口统计学、医学特征和避孕措施的标准化问卷。
共有283名妇女同意参与研究，她们的中位年龄为36岁，平均产次为1.7次。仅22.3%的病例为初产妇，54.8%的病例与伴侣同住。68.2%的病例与现任伴侣没有孩子。51.6%的病例中伴侣知晓其艾滋病毒感染状况。92.9%的病例正在接受抗逆转录病毒治疗，CD4细胞中位数为382个/毫升。大多数患者（62.9%）宣称他们正在使用现代避孕方法。他们主要使用注射用孕激素（45.5%）和避孕植入物（32.6%）。只有17.4%的人采取了双重保护措施。中等及以上教育程度（比值比=2.23 [1.35 - 3.69]，p = 0.01）、多产（比值比=1.84 [1.11 - 3.06]，p = 0.002）以及向伴侣透露艾滋病毒阳性状态（比值比=1.86 [1.14 - 3.03]，p < 0.01）是与采取避孕措施显著相关的因素。
根据我们的经验，感染艾滋病毒妇女的避孕措施总体上令人沮丧。制定战略以改善将计划生育纳入感染艾滋病毒妇女的管理至关重要。
