Awareness and Interest in Intrauterine Contraceptive Device Use among HIV-Positive Women in Cape Town, South Africa

OBJECTIVE To assess awareness of and interest in intrauterine contraceptive device (IUCD) use among HIV-positive women in Cape Town, South Africa. DESIGN Cross-sectional survey. METHODS HIV-positive women aged 18 through 45 years presenting for care at a primary health care clinic in Cape Town, South Africa participated in this study. Consented participants completed a staff-administered questionnaire in a private setting. Descriptive statistics were generated. Comparisons between demographic and reproductive health-related variables and IUCD awareness and interest were performed with multiple logistic regression. Analyses for IUCD interest excluded women with prior surgical sterilization. RESULTS Of 277 HIV-positive women, 37% were aware of the IUCD; awareness was independently associated with greater age (adjusted odds ratio (AOR)=1.15, 95%; confidence interval (CI): 1.10-1.20) and not switching contraceptive methods in the last year (AOR=2.45, 95% CI: 1.03-5.83). Following an IUCD information session, 86% of women (n=206/240) were interested in IUCD use. IUCD interest was inversely associated with age (AOR=0.91, 95% CI: 0.86-0.97) and marginally positively associated with current menstrual bleeding pattern complaints (AOR=2.14, 95% CI: 0.98-4.68). CONCLUSIONS Despite low levels of method awareness, HIV-positive women in this setting are frequently interested in IUCD use, indicating need for programming to expand method access.