Prevalence and Correlates of Use of Safer Conception Methods in a Prospective Cohort of Ugandan HIV-affected Couples with Fertility Intentions

Published in: AIDS Behavior (2017). doi:10.1007/s10461-017-1732-7

Posted on RAND.org on March 16, 2017

by Glenn Wagner, Sebastian Linnemayr, Kathy Goggin, Deborah Mindry, Jolly Beyeza-Kashesya, Sarah Finocchario-Kessler, Eric Robinson, Josephine Birungi, Rhoda K Wanyenze

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Research Question

  1. What safer conception methods (SCM) do Ugandan couples who are seeking to have children use to reduce HIV transmission between partners?

We examined the prevalence and correlates of safer conception methods (SCM) use in HIV-affected couples with fertility intentions. A prospective cohort of 400 HIV clients in Uganda who had fertility intentions with their partner was surveyed every 6 months for 24 months. Logistic regression analysis was used to determine individual, relationship and provider level predictors of SCM use. Over one-third (35%) reported any use of timed unprotected intercourse (TUI) during the study; use of other SCM was rare. Baseline predictors of any TUI use included lower social support, greater perceived provider stigma of childbearing, greater SCM awareness, greater control over sexual decision making in the relationship, inconsistent condom use, and the belief that a desire for childbearing impedes condom use. These findings highlight the need for policy and provider training regarding integration of safer conception counselling into family planning and reproductive health services for people living with HIV.

Key Findings

  • More than one-third of couples reported use of timed unprotected intercourse (TUI).
  • Other methods of safer conception were seldom used.
  • Lack of awareness of SCM was prevalent among participants.
  • Participants more likely to use the TUI method were more likely to be older, have been HIV-positive for longer, have an HIV-positive partner, or have greater awareness of SCM than other participants in the study.

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