Pregnancy desires, and contraceptive knowledge and use among prevention of mother-to-child transmission clients in Rwanda

AIDS. 2009 Nov;23 Suppl 1:S19-26. doi: 10.1097/01.aids.0000363774.91376.dc.


Objective: To understand pregnancy intentions and contraception knowledge and use among HIV-positive and negative women in the national prevention of mother-to-child transmission (PMTCT) program in Rwanda.

Design: A cross-sectional survey of 236 HIV-positive and 162 HIV-negative postpartum women interviewed within 12 months of their expected delivery date in 12 randomly selected public-sector health facilities providing PMTCT services.

Methods: : Bivariate analyses explored fertility intentions, and family planning knowledge and use by HIV status. Multivariate analysis identified socio-demographic and service delivery-related predictors of reporting a desire for additional children and modern family planning use.

Results: HIV-positive women were less likely to report wanting additional children than HIV-negative women (8 vs. 49%, P < 0.001), and although a majority of women reported discussing family planning with a health worker during their last pregnancy (HIV-positive 79% vs. HIV-negative 69%, P = 0.057), modern family planning use remained low in both groups (HIV-positive 43% vs. HIV-negative 12%, P < 0.001). Condoms were the most commonly used method among HIV-positive women (31%), whereas withdrawal was most frequently reported among HIV-negative women (19%). In multivariate analysis, HIV-negative women were 16 times more likely to report wanting additional children and nearly 85% less likely to use modern family planning. Women who reported making two or less antenatal care visits were 77% less likely to use modern family planning.

Conclusion: Our results highlight success in provision of family planning counseling in PMTCT services in Rwanda. As family planning use was low among HIV-positive and negative women, further efforts are needed to improve uptake of modern methods, including dual protection, in Rwandan PMTCT settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Contraception Behavior / psychology*
  • Contraception Behavior / statistics & numerical data
  • Family Planning Services / standards*
  • Female
  • HIV Infections / prevention & control
  • HIV Infections / psychology
  • HIV Infections / transmission*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pregnancy
  • Rwanda
  • Young Adult