Document 0302
 DOCN  M9650302
 TI    A family planning intervention to reduce vertical transmission of HIV in
       Rwanda.
 DT    9605
 AU    King R; Estey J; Allen S; Kegeles S; Wolf W; Valentine C; Serufilira A;
       Department of Epidemiology and Biostatistics, UCSF, USA.
 SO    AIDS. 1995 Jul;9 Suppl 1:S45-51. Unique Identifier : AIDSLINE
       MED/96085743
 AB    OBJECTIVES: Since contraception is an effective way of preventing the
       vertical transmission of HIV, we evaluated the impact of a family
       planning intervention on hormonal contraceptive use and incident
       pregnancy in a group of HIV-positive and HIV-negative urban Rwandan
       women. SUBJECTS AND METHODS: In a longitudinal cohort study, 502 women
       who were not pregnant or infertile and who had been previously HIV
       tested and counseled viewed an informational video about hormonal
       contraception followed by a facilitated discussion. They were given
       access to oral or injectable hormonal contraception and Norplant at the
       research clinic; those who used these methods were seen every 3 months.
       RESULTS: Of the 330 HIV-positive and 172 HIV-negative women who
       underwent the intervention, 120 either became new hormonal method users
       (n = 40), continued their previous use of a hormonal method (n = 64), or
       switched to another hormonal method (n = 16) following the intervention.
       There was a shift to use of longer lasting hormonal methods, and the
       annualized attrition rate was < 15%, compared to > 50% prior to the
       intervention. Rates of oral and injectable contraceptive use were
       similar among HIV-positive and HIV-negative women. Nine per cent of
       HIV-positive women became pregnant in the year after the intervention
       compared to 22% in a prior 12 month period when contraceptives were not
       provided at the study site. The corresponding proportions for
       HIV-negative women were 20% after the intervention versus 30% before the
       intervention. CONCLUSIONS: Access to and information about hormonal
       contraceptives resulted in increased use and reduced attrition among
       both HIV-positive and HIV-negative women in this study. The reduction in
       incident pregnancy was greatest among HIV-positive women, suggesting
       that factors other than access to hormonal contraceptives may have
       influenced fertility outcomes. Knowledge of HIV serostatus may have an
       important influence on family planning decisions.
 DE    Adolescence  Adult  Contraception Behavior  *Developing Countries
       Disease Transmission, Vertical  Family Planning  Female  Follow-Up
       Studies  Health Education  Health Services Accessibility  Human  HIV
       Infections/*PREVENTION & CONTROL/TRANSMISSION  Infant, Newborn
       Knowledge, Attitudes, Practice  Pregnancy  Pregnancy Complications,
       Infectious/*PREVENTION & CONTROL  Program Evaluation  Rwanda  Support,
       Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.  Urban Population  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).