Contraceptive, condom and dual method use at last coitus among perinatally and horizontally HIV-infected young women in Atlanta, Georgia

To evaluate factors within the social-ecological framework associated with most or moderately effective contraception, condom and dual method use at last coitus among young, HIV-infected women in Atlanta. This is a cross-sectional study conducted from November, 2013 until August, 2015 at the Grady I...

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Bibliographic Details
Published in:	PloS one 2018-09, Vol.13 (9), p.e0202946-e0202946
Main Authors:	Haddad, Lisa B, Brown, Jennifer L, King, Caroline, Gause, Nicole K, Cordes, Sarah, Chakraborty, Rana, Kourtis, Athena P
Format:	Article
Language:	eng
Subjects:	Acquired immune deficiency syndrome Adolescent Adult AIDS Analysis Antiretroviral agents Antiretroviral therapy Biology and Life Sciences Coitus Condoms Condoms - statistics & numerical data Contraception Contraception Behavior - statistics & numerical data Contraceptives Cross-Sectional Studies Disease prevention Disease Transmission, Infectious - prevention & control Ecological effects Female Georgia Health aspects HIV HIV Infections - prevention & control HIV Infections - transmission HIV positive HIV seropositivity Human immunodeficiency virus Humans Infectious Disease Transmission, Vertical - prevention & control Infectious diseases Medicine and Health Sciences Pregnancy Sexual intercourse Sexually transmitted diseases STD Women Women's health Young Adult Young adults
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Summary:	To evaluate factors within the social-ecological framework associated with most or moderately effective contraception, condom and dual method use at last coitus among young, HIV-infected women in Atlanta. This is a cross-sectional study conducted from November, 2013 until August, 2015 at the Grady Infectious Disease Clinic in Atlanta, Georgia. We recruited perinatally and horizontally HIV-infected women of ages 14-30 years to complete an audio computer-assisted self-interview. We evaluated factors within a social-ecological framework associated with most or moderately effective contraceptive use (hormonal contraception or an IUD), condom use, and dual method use (use of condom and most or moderately effective contraceptive) at last coitus. Of 103 women enrolled, 74 reported a history of sexual activity. The average age was 22.1; 89% were African American, 52% were perinatally infected, 89% received combination antiretroviral therapy, and 63% had undetectable viral loads. At last coitus, 46% reported most or moderately effective contraception, 62% reported condom use and 27% reporting dual-method use. The odds of most or moderately effective contraceptive use was significantly reduced among those with detectable viral loads (versus undetectable viral loads; aOR 0.13 [0.04, 0.38]). Older age (aOR 0.85 [0.74, 0.98] and more frequent coitus (>once/week versus < = once/week; aOR 0.24 [0.08, 0.72]) was significantly associated with reduced condom use. Having a detectable viral load (versus undetectable viral loads; aOR 0.13 [0.03, 0.69]) and more frequent coitus (>once/week versus < = once/week; aOR 0.14 [0.03,0.82]), was associated with reduced dual method use, while being enrolled in school (aOR 5.63 [1.53, 20.71]) was significantly associated with increased dual method use. Most or moderately effective contraception, condom and dual method use remained inadequate in this cohort of young HIV-infected women. Individual-level interventions are needed to increase the uptake of dual methods with user-independent contraceptives.
ISSN:	1932-6203 1932-6203