Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal
Identifieur interne : 002D26 ( Ncbi/Merge ); précédent : 002D25; suivant : 002D27Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal
Auteurs : Julia Raifman [États-Unis, Afrique du Sud] ; Terusha Chetty [Afrique du Sud] ; Frank Tanser [Afrique du Sud] ; Tinofa Mutevedzi [Afrique du Sud] ; Philippa Matthews [Afrique du Sud] ; Kobus Herbst [Afrique du Sud] ; Deenan Pillay [Afrique du Sud, Royaume-Uni] ; Till B Rnighausen [États-Unis, Afrique du Sud]Source :
- Journal of Acquired Immune Deficiency Syndromes (1999) [ 1525-4135 ] ; 2014.
Abstract
Supplemental Digital Content is Available in the Text.
Url:
DOI: 10.1097/QAI.0000000000000373
PubMed: 25436821
PubMed Central: 4251916
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<author><name sortKey="Kipp, W" uniqKey="Kipp W">W Kipp</name>
</author>
<author><name sortKey="Jhangri, Gs" uniqKey="Jhangri G">GS Jhangri</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Homsy, J" uniqKey="Homsy J">J Homsy</name>
</author>
<author><name sortKey="Bunnell, R" uniqKey="Bunnell R">R Bunnell</name>
</author>
<author><name sortKey="Moore, D" uniqKey="Moore D">D Moore</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Myer, L" uniqKey="Myer L">L Myer</name>
</author>
<author><name sortKey="Carter, Rj" uniqKey="Carter R">RJ Carter</name>
</author>
<author><name sortKey="Katyal, M" uniqKey="Katyal M">M Katyal</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schwartz, Sr" uniqKey="Schwartz S">SR Schwartz</name>
</author>
<author><name sortKey="Mehta, Sh" uniqKey="Mehta S">SH Mehta</name>
</author>
<author><name sortKey="Taha, Te" uniqKey="Taha T">TE Taha</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Moscoe, E" uniqKey="Moscoe E">E Moscoe</name>
</author>
<author><name sortKey="Bor, J" uniqKey="Bor J">J Bor</name>
</author>
<author><name sortKey="B Rnighausen, T" uniqKey="B Rnighausen T">T Bärnighausen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bor, J" uniqKey="Bor J">J Bor</name>
</author>
<author><name sortKey="Moscoe, E" uniqKey="Moscoe E">E Moscoe</name>
</author>
<author><name sortKey="Mutevedzi, P" uniqKey="Mutevedzi P">P Mutevedzi</name>
</author>
</analytic>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr</journal-id>
<journal-id journal-id-type="publisher-id">qai</journal-id>
<journal-title-group><journal-title>Journal of Acquired Immune Deficiency Syndromes (1999)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1525-4135</issn>
<issn pub-type="epub">1944-7884</issn>
<publisher><publisher-name>JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25436821</article-id>
<article-id pub-id-type="pmc">4251916</article-id>
<article-id pub-id-type="publisher-id">QAIV14852</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0000000000000373</article-id>
<article-id pub-id-type="art-access-id">00008</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Supplement Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Raifman</surname>
<given-names>Julia</given-names>
</name>
<degrees>SM</degrees>
<xref ref-type="aff" rid="aff1">*</xref>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chetty</surname>
<given-names>Terusha</given-names>
</name>
<degrees>FCPHM, MBChB, DCH, MMed</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tanser</surname>
<given-names>Frank</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mutevedzi</surname>
<given-names>Tinofa</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Matthews</surname>
<given-names>Philippa</given-names>
</name>
<degrees>MBBS, DCH, FRCGP</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Herbst</surname>
<given-names>Kobus</given-names>
</name>
<degrees>MBChB, MSc, FFCH</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pillay</surname>
<given-names>Deenan</given-names>
</name>
<degrees>MBBS, PhD</degrees>
<xref ref-type="aff" rid="aff2">†</xref>
<xref ref-type="aff" rid="aff3">‡</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Bärnighausen</surname>
<given-names>Till</given-names>
</name>
<degrees>MD, ScD</degrees>
<xref ref-type="aff" rid="aff1">*</xref>
<xref ref-type="aff" rid="aff2">†</xref>
</contrib>
<aff id="aff1"><label>*</label>
Department of Global Health and Population, Harvard School of Public Health, Boston, MA;</aff>
<aff id="aff2"><label>†</label>
Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba, South Africa; and</aff>
<aff id="aff3"><label>‡</label>
Division of Infection & Immunity University College London, London, United Kingdom.</aff>
</contrib-group>
<author-notes><corresp>Correspondence to: Till Bärnighausen, MD, ScD, Department of Global Health and Population, Harvard School of Public Health, Boston, MA; and Africa Centre for Health and Population Studies (e-mail: <email>tbarnighausen@africacentre.ac.za</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>1</day>
<month>12</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>07</day>
<month>11</month>
<year>2014</year>
</pub-date>
<volume>67</volume>
<issue>Suppl 4</issue>
<fpage>S218</fpage>
<lpage>S227</lpage>
<permissions><copyright-statement>Copyright © 2014 by Lippincott Williams & Wilkins</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:type="simple" xlink:href="qai-67-s218.pdf"></self-uri>
<abstract abstract-type="toc"><p>Supplemental Digital Content is Available in the Text.</p>
</abstract>
<abstract><sec><title>Background:</title>
<p>For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa.</p>
</sec>
<sec><title>Methods:</title>
<p>We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15–49 years (N = 3169), controlling for a wide range of potential confounders.</p>
</sec>
<sec><title>Findings:</title>
<p>Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4–7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4–7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (<italic>P</italic>
= 0.030)/3.5 pp (<italic>P</italic>
= 0.001), (2) 10.3 pp (<italic>P</italic>
= 0.003)/5.2 pp (<italic>P</italic>
= 0.007), and (3) 21.6 pp (<italic>P</italic>
< 0.001)/11.2 pp (<italic>P</italic>
< 0.001).</p>
</sec>
<sec><title>Conclusions:</title>
<p>Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice.</p>
</sec>
</abstract>
<kwd-group><title>Key Words:</title>
<kwd>unintended pregnancy</kwd>
<kwd>HIV</kwd>
<kwd>AIDS</kwd>
<kwd>reproductive health</kwd>
<kwd>contraception</kwd>
<kwd>condoms</kwd>
<kwd>HIV transmission</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>OPEN-ACCESS</meta-name>
<meta-value>TRUE</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
<li>Massachusetts</li>
</region>
<settlement><li>Londres</li>
</settlement>
<orgName><li>University College de Londres</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Raifman, Julia" sort="Raifman, Julia" uniqKey="Raifman J" first="Julia" last="Raifman">Julia Raifman</name>
</region>
<name sortKey="B Rnighausen, Till" sort="B Rnighausen, Till" uniqKey="B Rnighausen T" first="Till" last="B Rnighausen">Till B Rnighausen</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Raifman, Julia" sort="Raifman, Julia" uniqKey="Raifman J" first="Julia" last="Raifman">Julia Raifman</name>
</noRegion>
<name sortKey="B Rnighausen, Till" sort="B Rnighausen, Till" uniqKey="B Rnighausen T" first="Till" last="B Rnighausen">Till B Rnighausen</name>
<name sortKey="Chetty, Terusha" sort="Chetty, Terusha" uniqKey="Chetty T" first="Terusha" last="Chetty">Terusha Chetty</name>
<name sortKey="Herbst, Kobus" sort="Herbst, Kobus" uniqKey="Herbst K" first="Kobus" last="Herbst">Kobus Herbst</name>
<name sortKey="Matthews, Philippa" sort="Matthews, Philippa" uniqKey="Matthews P" first="Philippa" last="Matthews">Philippa Matthews</name>
<name sortKey="Mutevedzi, Tinofa" sort="Mutevedzi, Tinofa" uniqKey="Mutevedzi T" first="Tinofa" last="Mutevedzi">Tinofa Mutevedzi</name>
<name sortKey="Pillay, Deenan" sort="Pillay, Deenan" uniqKey="Pillay D" first="Deenan" last="Pillay">Deenan Pillay</name>
<name sortKey="Tanser, Frank" sort="Tanser, Frank" uniqKey="Tanser F" first="Frank" last="Tanser">Frank Tanser</name>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Pillay, Deenan" sort="Pillay, Deenan" uniqKey="Pillay D" first="Deenan" last="Pillay">Deenan Pillay</name>
</region>
</country>
</tree>
</affiliations>
</record>
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