Journal article
Contraceptive adherence among HIV-infected women in Malawi: a randomized controlled trial of the copper intrauterine device and depot medroxyprogesterone acetate
Contraception (Stoneham), Vol.88(6), pp.737-743
12/01/2013
DOI: 10.1016/j.contraception.2013.08.006
PMCID: PMC4108248
PMID: 24060297
Abstract
To evaluate contraceptive adherence to the copper intrauterine device (Cu-IUD) and the injectable depot medroxyprogesterone acetate (DMPA) among women with HIV in Lilongwe, Malawi.
We randomized 200 HIV-infected women on highly active antiretroviral therapy (HAART) to either the Cu-IUD or DMPA and followed these women prospectively, evaluating adherence and factors associated with nonadherence.
There was no difference in contraceptive adherence: 68% of Cu-IUD and 65% of DMPA users were adherent at 48 weeks. Receiving first-choice contraceptive was not associated with adherence. Women commonly cited partner's disapproval as an indication for discontinuation. Women who experienced heavy menstruation and first-time contraceptive users were more likely to be nonadherent. Among ongoing users at study conclusion, 95% were happy with their method, and 98% would recommend their method to a friend.
Contraceptive adherence between the Cu-IUD and DMPA was similar at 1 year. With similar adherence and similar high rates of satisfaction among users of both methods at 1 year, the Cu-IUD offers a hormone-free alternative to DMPA.
Adherence to the Cu-IUD and DMPA is similar at 1 year among HIV-infected women on HAART in a randomized controlled trial. Despite high method satisfaction, partner disapproval and heavy bleeding contribute to reduced adherence. Receiving a method that differs from participant's first-choice method did not influence adherence.
Details
- Title: Subtitle
- Contraceptive adherence among HIV-infected women in Malawi: a randomized controlled trial of the copper intrauterine device and depot medroxyprogesterone acetate
- Creators
- Lisa B. Haddad - Emory UniversityCarrie Cwiak - Emory UniversityDenise J. Jamieson - Emory UniversityCaryl Feldacker - Office of the National Coordinator for Health Information TechnologyHannock Tweya - Lighthouse TrustMina Hosseinipour - Ministry of HealthIrving Hoffman - University of North Carolina at Chapel HillAmy G. Bryant - University of North Carolina at Chapel HillGretchen S. Stuart - University of North Carolina at Chapel HillIsaac Noah - Lighthouse TrustLinly Mulundila - Lighthouse TrustBernadette Samala - Lighthouse TrustPatrick Mayne - Brown UniversitySam Phiri - Lighthouse TrustLighthouse UNC Emory Family Planning Study Group
- Resource Type
- Journal article
- Publication Details
- Contraception (Stoneham), Vol.88(6), pp.737-743
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.contraception.2013.08.006
- PMID
- 24060297
- PMCID
- PMC4108248
- ISSN
- 0010-7824
- eISSN
- 1879-0518
- Language
- English
- Date published
- 12/01/2013
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446425102771
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