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dc.contributor.authorOShea, Michele*
dc.date.accessioned2015-04-13T17:13:16Zen
dc.date.available2015-04-13T17:13:16Zen
dc.date.issued2015-04-13
dc.identifier.urihttp://hdl.handle.net/10150/536225
dc.descriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.en
dc.description.abstractBackground and Significance: Both HIV and unintended pregnancies have been associated with adverse maternal, perinatal, and infant outcomes. Malawi is a country with both high HIV prevalence and rates of unintended pregnancy, where 13% of women aged 15‐49 years have HIV, and 41% of pregnancies are unintended. Research Question: The objectives of this study were to describe the most recent pregnancy intentions and family planning preferences of HIV‐infected and HIV‐uninfected postpartum Malawian women, and to assess whether HIV status is associated with fertility desire and knowledge of intrauterine contraception (IUC) and the subdermal contraceptive implant. Methods: We conducted a cross‐sectional analysis of the baseline characteristics of Malawian women enrolled in a prospective cohort study assessing postpartum contraceptive uptake and continuation. Women at a government hospital completed a baseline survey assessing reproductive history, family planning preferences, and knowledge of IUC and the implant. We used Pearson’s chi‐square tests to compare these parameters between HIV‐infected and HIV‐uninfected women. Modified Poisson regression was performed to assess the association between HIV status and fertility desire and knowledge about IUC and the implant. Results: Of 634 postpartum women surveyed, HIV‐infected women were more likely to report their most recent pregnancy was unintended (49% versus 37%, p=0.004). Nearly all women (97%) did not want a child in the next two years but HIV‐infected women were more likely to desire no more children (adjusted PR: 1.59; 95% CI: 1.33, 1.89). HIV‐ infected women were also less likely to know that IUC (adjusted PR 0.72; 95% CI: 0.61, 0.84) and the implant (adjusted PR 0.83; 95% CI: 0.75, 0.92) are safe during breastfeeding. Conclusion: Postpartum women strongly desire family spacing and many HIV‐infected postpartum women desire no more children, suggesting an important role for these long‐acting methods. Education about the efficacy and safety of IUC and the implant particularly during breastfeeding may facilitate postpartum use.
dc.language.isoen_USen
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.subjectMalawien
dc.subject.meshHIVen
dc.subject.meshFertilityen
dc.subject.meshContraceptionen
dc.subject.meshPostpartum Perioden
dc.titleEFFECT OF HIV STATUS ON FERTILITY DESIRE AND KNOWLEDGE OF LONG‐ACTING REVERSIBLE CONTRACEPTION OF POSTPARTUM MALAWIAN WOMENen_US
dc.typetext; Electronic Thesisen
dc.contributor.departmentThe University of Arizona College of Medicine - Phoenixen
dc.description.collectioninformationThis item is part of the College of Medicine - Phoenix Scholarly Projects 2015 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.en_US
dc.contributor.mentorTang, Jenniferen
refterms.dateFOA2018-06-30T19:11:51Z
html.description.abstractBackground and Significance: Both HIV and unintended pregnancies have been associated with adverse maternal, perinatal, and infant outcomes. Malawi is a country with both high HIV prevalence and rates of unintended pregnancy, where 13% of women aged 15‐49 years have HIV, and 41% of pregnancies are unintended. Research Question: The objectives of this study were to describe the most recent pregnancy intentions and family planning preferences of HIV‐infected and HIV‐uninfected postpartum Malawian women, and to assess whether HIV status is associated with fertility desire and knowledge of intrauterine contraception (IUC) and the subdermal contraceptive implant. Methods: We conducted a cross‐sectional analysis of the baseline characteristics of Malawian women enrolled in a prospective cohort study assessing postpartum contraceptive uptake and continuation. Women at a government hospital completed a baseline survey assessing reproductive history, family planning preferences, and knowledge of IUC and the implant. We used Pearson’s chi‐square tests to compare these parameters between HIV‐infected and HIV‐uninfected women. Modified Poisson regression was performed to assess the association between HIV status and fertility desire and knowledge about IUC and the implant. Results: Of 634 postpartum women surveyed, HIV‐infected women were more likely to report their most recent pregnancy was unintended (49% versus 37%, p=0.004). Nearly all women (97%) did not want a child in the next two years but HIV‐infected women were more likely to desire no more children (adjusted PR: 1.59; 95% CI: 1.33, 1.89). HIV‐ infected women were also less likely to know that IUC (adjusted PR 0.72; 95% CI: 0.61, 0.84) and the implant (adjusted PR 0.83; 95% CI: 0.75, 0.92) are safe during breastfeeding. Conclusion: Postpartum women strongly desire family spacing and many HIV‐infected postpartum women desire no more children, suggesting an important role for these long‐acting methods. Education about the efficacy and safety of IUC and the implant particularly during breastfeeding may facilitate postpartum use.


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