Human Immunodeficiency Virus Serodiscordance and Dual Contraceptive Method Use Among Human Immunodeficiency Virus-infected Men and Women in Lilongwe, Malawi.

• Type of Material: Article
• Authors: Blessings Gausi, University of North Carolina Project, Lilongwe, Malawi.; Maganizo B. Chagomerana, University of North Carolina Project, Lilongwe, Malawi.; Jennifer H. Tang, University of North Carolina Project, Lilongwe, Malawi.; Mina C. Hosseinipour, University of North Carolina Project, Lilongwe, Malawi.; Lisa Haddad, Emory University; Tweya Hannock, Kamuzu Central Hospital; Sam Phiri, Kamuzu Central Hospital
• Language: English
• Date: 2018-10-11
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/OLQ.0000000000000868
• Title of Journal or Parent Work: Sexually Transmitted Diseases
• ISSN: 0148-5717
• Volume: 45
• Issue: 11
• Start Page: 747
• End Page: 753
• Grant/Funding Information: This project was supported by a grant from the Society of Family Planning (PI: Lisa Haddad).
• Keywords: Serodiscordance; Men; Women; Immunodeficiency; Virus; Malawi; Duel Contraception
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Immunology

Abstract

BACKGROUND: Some human immunodeficiency virus (HIV) serodiscordant couples are faced with the dual challenge of preventing HIV transmission to the uninfected partner and avoiding unintended pregnancy. Therefore, we hypothesized that serodiscordance is associated with dual method use at last sex. METHODS: We analyzed data from a cross-sectional survey of HIV-infected men and women attending 2 ante-retroviral therapy clinics in Lilongwe, Malawi. We used Fisher exact test and Wilcoxon rank sum to assess for associations between serodiscordance, covariates, and dual method use. Multivariable logistic regression was used to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI) of dual method use at last sex, comparing serodiscordant to seroconcordant relationships. Separate analyses were conducted for men and women. RESULTS: We surveyed 253 HIV-infected men, of which 44 (17.4%) were in a known serodiscordant relationship and 63 (24.9%) were using dual methods at last sex. Likewise, among 302 HIV-infected women surveyed, 57 (18.9%) were in a known serodiscordant relationship, and 80 (26.5%) were using dual method at last sex. Serodiscordance was not significantly associated with dual method use at last sex for among HIV-infected men (aOR, 0.62; 95% CI, 0.27-1.44) or women (aOR, 1.21; 95% CI, 0.59-2.47). CONCLUSION: Dual method use was low among all HIV-infected individuals, irrespective of their partner's HIV status. Given these findings, we recommend greater efforts to encourage HIV providers to counsel their patients about the importance of dual method use to prevent both unintended pregnancy and sexually transmitted infections.