Document Detail


Impact of long-term contraceptive promotion on incident pregnancy: a randomized controlled trial among HIV-positive couples in Lusaka, Zambia.
MedLine Citation:
PMID:  23202814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the impact of family planning promotion on incident pregnancy in a combined effort to address Prongs 1 and 2 of prevention of mother-to-child transmission of HIV.
DESIGN: We conducted a factorial randomized controlled trial of 2 video-based interventions.
METHODS: "Methods" and "Motivational" messages promoted long-term contraceptive use among 1060 couples with HIV in Lusaka, Zambia.
RESULTS: Among couples not using contraception before randomization (n = 782), the video interventions had no impact on incident pregnancy. Among baseline contraceptive users, viewing the "Methods video" which focused on the intrauterine device and contraceptive implant was associated with a significantly lower pregnancy incidence [hazard ratio (HR) = 0.38; 95% confidence interval (CI): 0.19 to 0.75] relative to those viewing control and/or motivational videos. The effect was strongest in concordant positive couples (HR = 0.22; 95% CI: 0.08 to 0.58) and couples with HIV-positive women (HR = 0.23; 95% CI: 0.09 to 0.55).
CONCLUSIONS: The "Methods video" intervention was previously shown to increase uptake of long-acting contraception and to prompt a shift from daily oral contraceptives to quarterly injectables and long-acting methods such as the intrauterine device and implant. Follow-up confirms sustained intervention impact on pregnancy incidence among baseline contraceptive users, in particular couples with HIV-positive women. Further work is needed to identify effective interventions to promote long-acting contraception among couples who have not yet adopted modern methods.
Authors:
Kristin M Wall; Bellington Vwalika; Lisa Haddad; Naw H Khu; Cheswa Vwalika; William Kilembe; Elwyn Chomba; Rob Stephenson; David Kleinbaum; Azhar Nizam; Ilene Brill; Amanda Tichacek; Susan Allen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  63     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-11     Completed Date:  2013-06-24     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-95     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Contraception / methods*
Contraception Behavior / statistics & numerical data*
Counseling / methods*
Family Characteristics
Family Planning Services
Female
HIV Infections / epidemiology,  prevention & control*,  transmission
HIV Seropositivity / epidemiology*,  transmission
Health Knowledge, Attitudes, Practice
Humans
Male
Pregnancy
Sex Education
Treatment Outcome
Videotape Recording / methods
Zambia / epidemiology
Grant Support
ID/Acronym/Agency:
D43 TW001042/TW/FIC NIH HHS; P30 AI027767/AI/NIAID NIH HHS; P30 AI050409/AI/NIAID NIH HHS; R01 AI051231/AI/NIAID NIH HHS; R01 AI51231/AI/NIAID NIH HHS; R01 HD040125/HD/NICHD NIH HHS; R01 HD40125/HD/NICHD NIH HHS; R01 MH066767/MH/NIMH NIH HHS
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