Predictors of Dual Contraception among HIV Discordant Relationships in Zambia Open Access

Abstract

Background: Mother to child transmission and unintended pregnancy are major concerns among HIV discordant couples. Dual contraception use is proposed as way to increase pregnancy prevention and contraception effectiveness for such high risk couples. Investigation on predictors of dual contraception use among HIV discordant couples is not well documented.

Methods: To further examine dual contraception trends, this study utilized a longitudinal cohort of married and cohabitating Zambian couples recruited from 1994 to 2012 to participate in HIV counseling and testing (CVCT) services. Demographic, family planning, sexual history, and clinical measures were collected as possible predictors of dual contraception use.

Results: Overall increasing number of male lifetime sex partners, male reporting having a STI in the previous year, female being post-partum, and the male wanting a child within the next year best predicted dual use among HIV positive female discordant couples. For HIV positive male discordant couples, decreasing number of female lifetime sex partners, increasing number of male lifetime sex partners, female being post-partum, and decreasing fertility intentions of both male and female best predicted dual use.

Conclusions: Final models suggest males and post-partum female populations are particularly important groups to advocate increased dual contraception use. Increasing fertility desires across HIV discordant couples require expanded family planning outreach.

Table of Contents

• Background. 1
• Introduction. 8
• Methods. 10
• Results. 13
• Discussion. 16
• Conclusions. 18
• References. 19
• Tables. 23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	HIV contraception discordant dual methods modern contraception couples dual contraception Zambia
Committee Chair / Thesis Advisor	Wall, Kristin, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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