Pregnancy and contraception use among urban Rwandan women after HIV testing and counseling

Am J Public Health. 1993 May;83(5):705-10. doi: 10.2105/ajph.83.5.705.


Objectives: This study examined hormonal contraceptive use and pregnancy in urban Rwandan women, following human immunodeficiency virus (HIV) antibody testing and counseling.

Methods: A sample of 1458 childbearing urban Rwandan women aged 18 to 35 years was tested and followed for 2 years.

Results: At enrollment, 17% of 998 HIV-negative women and 11% of 460 HIV-positive women were pregnant, and 17% vs 23%, respectively, were using hormonal contraceptives. One year later, half of the HIV-positive and one third of the HIV-negative hormonal-contraceptive users had discontinued use. The 2-year incidence of pregnancy was 43% in HIV-positive and 58% in HIV-negative women. HIV-positive women with fewer than four children were more likely to become pregnant than those with four or more; this association persisted in multivariate analyses but was not noted among HIV-negative women. At the end of the study, over 40% of non-users said that they would use hormonal contraception if it was provided at the study clinic, but 40% of HIV-positive women desired more children.

Conclusions: Research is needed to identify the practical and psychosocial obstacles to effective long-term contraception among HIV-positive women. HIV counseling programs must specifically address the issue of childbearing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis*
  • Adolescent
  • Adult
  • Attitude
  • Contraception Behavior*
  • Counseling*
  • Female
  • HIV Seropositivity
  • Humans
  • Multivariate Analysis
  • Pregnancy*
  • Rwanda
  • Sampling Studies