Predictors of Contraceptive Attitudes and Use among HIV-Positive and HIV-Negative Rwandan Women

Adebola Adedimeji, Institute for Public Health Sciences (IPHS)
Donald R. Hoover, Rutgers University
Qiuhu Shi, New York Medical College, John Stroger Hospital and Rush University
Mardge H. Cohen, John Stroger Hospital and Rush University
Eugene Mutimura, Women's Equity in Access to Care and Treatment (WE-ACTx)
Agnes Binagwaho, Ministry of Health, Rwanda
Kathryn Anastos, Montefiore Medical Center and Albert Einstein College of Medicine

Contraception can help reduce the dual burden of high fertility and high HIV prevalence in sub-Saharan Africa, but significant barriers remain regarding access and use. We describe the characteristics of and factors associated with contraceptive practice among HIV-positive and HIV-negative women in Rwanda. The analysis includes 395 HIV-positive and 76 HIV-negative women who desired not to become pregnant in the previous 6 months. Univariate and multivariate logistic regression models were fitted to determine the clinical and demographic characteristics that predict contraceptive use. Marital/partner status, partner’s knowledge of a woman’s HIV status, and age were strong predictors of contraceptive use. Overall, condoms, abstinence, and hormonal methods were the most practiced, though differences existed by HIV status. Less than 10% of women were not using any contraception. Important differences between HIV-positive and HIV-negative women with regard to contraceptive use should be addressed by interventions seeking to improve contraceptive prevalence.