Contraceptive knowledge and practice among HIV-positive women receiving antiretroviral therapy at a district hospital in KwaZulu-Natal

Objectives: To determine the knowledge and use of contraceptives by HIV-positive women attending an ART clinic. Design: Observational descriptive cross-sectional study. Setting and subjects: Many human immunodeficiency virus (HIV)-positive South African women fall pregnant each year while receiving antiretroviral therapy (ART). In 2010, 2 056 women of childbearing age attended the ART clinic at a district hospital south of Durban. Between October 2010 and June 2011, data were collected using a validated questionnaire from 400 women on their contraceptive knowledge and use. Women over 18 years of age who consented to participate, and who had been receiving ART for more than a month, were eligible for participation in the study. Outcome measures: Contraceptive knowledge and use. Results: All participants had received counselling on male condom use. The majority of HIV-positive women receiving ART preferred the male condom as their contraception of choice. Knowledge of male condoms was excellent, but only 66% of the study group used condoms, and just over 50% used a dual method of contraception (male condoms plus another contraceptive method). While 97% of participants were knowledgeable about injectable contraception, only 40% used the latter as a form of contraception. Ninety-two per cent of the participants reported recent sexual activity, 14% had fallen pregnant while receiving ART, and 64% planned on having a child in the future. Conclusion: The low use of dual contraception was a cause for concern. Recommendations include the integration of family planning services into HIV care at all ART sites. This should promote proper fertility management for women receiving ART.