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Contraceptive Use in HIV-Positive Women

The objective was to describe contraceptive use in women with HIV infection in France over the past decade. The study included 575 sexually active women of reproductive age, who knew the serologic status of their steady partners. It is part of a prospective observational study initiated in 1993 that was designed to investigate the gynecologic status of HIV-infected women. Women answered a standardized questionnaire about contraceptive use and sexual activity at each semiannual visit. Multivariate models were used to investigate parameters associated with the use of contraceptive methods. Contraceptive use was reported in 91% of the visits of women with an HIV-seronegative partner and 69% of women with an HIV-seropositive partner (P = 0.0001). Consistent condom use was higher in serodiscordant couples than in seroconcordant couples (odds ratio [OR] = 6.1, 95% CI = 0.1–0.2, P < 0.001). The use of oral contraception and intrauterine devices was higher in seroconcordant than in serodiscordant couples (OR = 2.1, 95% CI =1.5–2.9, P < 0.001). Among women with an HIV-seronegative partner, the use of oral contraception and intrauterine devices decreased after the introduction of highly active antiretroviral therapy in 1998 (P = 0.02) and was higher in couples with inconsistent condom use (OR = 2.0, 95% CI = 1.3–3.3). These data emphasize that contraception counseling should include a discussion on reproductive issues as well as transmission of HIV and other sexually transmitted infections, taking into account the partner's serostatus.