Contraceptive Preference Among Women at Risk of HIV Acquisition in a Preparatory Screening Study for a Phase III Microbicide Trial in South Western Uganda
Contraceptive preferences of women at risk for HIV acquisition are not well documented. We report on contraceptive choices among women residing in small townships in southwestern Uganda. This was part of preparatory efforts for recruitment into the Ring Study, a phase 3 microbicide trial, between July 2013 and October 2014. Clinicians provided contraceptives per a woman’s choice. HIV testing and screening for other sexually transmitted infections were done at first contact and at screening for the trial. Contraceptive choice was summarized by demographics and regression analysis to show factors associated with use of the injectable method. Of 6725 women contacted, 489 were prescreened. Of these 489 women, most (306, 63%) were already using contraception. Injectables were most preferred (58.7%), followed by implants (23.9%). Women living with a regular sexual partner preferred the injectable method (61.0%, P = 0.06), compared with other methods. Women at risk for HIV infection are willing to initiate use of modern contraceptives, which may reduce study dropout during intervention trials due to unintended pregnancy. Registration no: NCT01539226.
KeywordsContraceptives Contraceptive preference Women at high-risk Uganda
International Partnership for Microbicides’ (a not-for-profit product-development partnership) work is made possible by generous support from many donors including: the Bill and Melinda Gates Foundation, Irish Aid, the Ministry of Foreign Affairs of Denmark, the Ministry of Foreign Affairs of the Netherlands, the Norwegian Agency for Development Cooperation, the U.K. Department for International Development, the American people through the U.S. Agency for International Development, and the President’s Emergency Plan for AIDS Relief. We thank the study team who worked tirelessly in planning, recruitment and data collection for this study; Anatoli Kamali, Anita Kabarambi, Eugene Ruzagira, Ubaldo Bahemuka, Margaret Kalibbala Lutwama, Sarah Nakato, Faith Ruth Naddunga, Beatrice Kimono Washi, Leah Mbabazi, Agnes Nakazzi Bukenya, Juliet Kyomugisha, Sophie Nalutaaya, Vincent Basajja, Sylvia Masawi, Henry Ssemaganda, Irene Nassuuna, Victoria Mugwaneza, Josephine Bayigga, Jael Nakalema, Richard Mawogole, Joseph Kitumba. Penelope Akankunda, Faith Namutosi, Angel Nansere, Richard Rwanyonga, Benjamin Twefeho, Paul Mayanja, Jennifer Nabatanzi, Kenneth Collin Mawanda, Aeron Namirembe, Kenneth Kugonza, Emanuel Aling, Paul Taire and Andrew Walungama Kiyingi. We also thank Janine Martins, IPM for reviewing the manuscript. We wish to acknowledge the support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, and R25 MH064712. We thank Matt Price, Rhoderick Machekano, Krysia Lindan and Wenjing Zheng for reviewing the manuscript under this program.
SK, AA, MO, AN designed the study and AA did the analysis. GA contributed to the writing and editing of the manuscript. SK and MO directed the work. All authors contributed to the interpretation of the results and critically commented and provided revisions to the manuscript.
The study was funded and sponsored by the International Partnership for Microbicides (www.ipmglobal.org) (IND # 110,659). For this manuscript, the funder participated in study design and manuscript review, but had no role in data analysis.
Compliance with Ethical Standards
All authors declare that they have no conflict of interest.
All study participants provided written informed consent before recruitment. The study was approved by the Uganda Virus Research Institute Research Ethics Committee and Uganda National Council for Science and Technology.
- 2.Singh S, Moore A, Bankole A, Mirembe F, Wulf D. Unintended pregnancy and induced abortion in Uganda: causes and consequences. New York: Guttmacher Institute; 2006.Google Scholar
- 3.Statistics UBo. Uganda Demographic and Health Survey: Key Indicators Report. Directorate of Population and Social Statistics, Uganda Bureau of Statistics; 2016.Google Scholar
- 9.UNAIDS guidance note on HIV and sex work; 2009. http://www.unaids.org/en/media/unaids/. Accessed 22 August 2016.
- 22.Health Mo. Uganda national guidelines for the syndromic management of sexually transmitted infections. STD Control Unit of the STD/AIDS Control programme. Ministry of Health, Uganda; 2010.Google Scholar
- 23.Centers for disease control and prevention. sexually transmitted diseases treatment guidelines. In: Services UDoHaH, editor. Office of surveillance, epidemiology, and laboratory services, centers for disease control and prevention (CDC), U.S. Department of Health and Human Services, MMWR 2010;59. No. RR-12.Google Scholar
- 27.United Nations. World Contraceptive Patterns. In: Affairs DoEaS, Division P, editors. New York: United Nations; 2013.Google Scholar
- 30.World Health Organization. Hormonal contraceptive eligibility for women at high risk of HIV. Department of Reproductive Health and Research, World Health Organization. 2017:20.Google Scholar
- 33.Kabagenyi A, Jennings L, Reid A, Nalwadda G, Ntozi J, Atuyambe L. Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda. Reprod Health. 2014;11(1):21.CrossRefPubMedPubMedCentralGoogle Scholar