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:  Publisher    
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 two video-based interventions. METHODS:: "Methods-focused" and "Motivational" messages promoted long-term contraceptive use among 1060 couples with HIV in Lusaka, Zambia. RESULTS:: Among couples not using contraception prior to randomization (N=782), the video interventions had no impact on incident pregnancy. Among baseline contraceptive users, viewing the "Methods" video which focused on the IUD and contraceptive implant was associated with a significantly lower pregnancy incidence (HR=0.38; 95%CI:0.19-0.75) relative to those viewing control and/or motivational videos. The effect was strongest in concordant positive couples (HR=0.22; 95%CI:0.08-0.58) and couples with HIV+ women (HR=0.23; 95%CI:0.09-0.55). CONCLUSIONS:: The "Methods video" intervention was previously shown to increase uptake of longer-acting contraception and to prompt a shift from daily oral contraceptives to quarterly injectables and long-acting methods such as the IUD 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 Htee 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     Date:  2012-11-29
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  -     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA, USA 2Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA 3Department of Global Health, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA, USA 4Department of Biostatistics and Bioinformatics, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA, USA 5Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA 6Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA All authors: Rwanda Zambia HIV Research Group, Dept of Pathology & Laboratory Medicine, School of Medicine and Hubert Dept of Global Health, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA, USA.
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