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Correlates of Injectable Contraceptive Discontinuation following HIV Seroconversion in an HIV Prevention Trial


Background: Injectable contraception (IC) is the most common form of highly effective contraception currently used in sub-Saharan Africa; however, its use has not been well described in HIV-infected women in the post-seroconversion period. This analysis aimed to examine factors associated with IC discontinuation following HIV seroconversion in an HIV prevention trial. Methods: Following HIV acquisition in a prevention trial, 255 African women were enrolled in a longitudinal observational study (MTN-015). IC use was evaluated at MTN-015 entry and at 3, 12, and 24 months. Correlates of IC discontinuation were examined by Cox proportional hazard modeling.Results: Of baseline IC users, 34% (61/182) of women with follow-up data discontinued use of IC without a non-barrier substitution. Having at least one child (adjusted HR 0.38, p= 0.03) and earning personal income (adjusted HR 0.58, p= 0.05) were associated with lower rates of IC discontinuation. Conclusion: IC discontinuation was common post-seroconversion in HIV-infected African women despite onsite contraceptive services. Many women with recently acquired HIV face complex decision-making regarding family planning.

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