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


  • Allen, S.
  • Serufilira, A.
  • Gruber, V.
  • Kegeles, S.
  • Van de Perre, P.
  • Carael, M.
  • Coates, T.J.


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.

Suggested Citation

  • Allen, S. & Serufilira, A. & Gruber, V. & Kegeles, S. & Van de Perre, P. & Carael, M. & Coates, T.J., 1993. "Pregnancy and contraception use among urban Rwandan women after HIV testing and counseling," American Journal of Public Health, American Public Health Association, vol. 83(5), pages 705-710.
  • Handle: RePEc:aph:ajpbhl:1993:83:5:705-710_2

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    Cited by:

    1. Siv Gustafsson & Seble Worku, 2007. "Teenage Motherhood and Long-run Outcomes in South Africa," Tinbergen Institute Discussion Papers 07-024/3, Tinbergen Institute.
    2. Sebnem Kalemli-Ozcan, 2012. "AIDS, “reversal” of the demographic transition and economic development: evidence from Africa," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(3), pages 871-897, July.
    3. Hopkins, Kristine & Maria Barbosa, Regina & Riva Knauth, Daniela & Potter, Joseph E., 2005. "The impact of health care providers on female sterilization among HIV-positive women in Brazil," Social Science & Medicine, Elsevier, vol. 61(3), pages 541-554, August.
    4. Chinhui Juhn & Sebnem Kalemli-Ozcan & Belgi Turan, 2013. "HIV and fertility in Africa: first evidence from population-based surveys," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(3), pages 835-853, July.
    5. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.
    6. Mantell, Joanne E. & Myer, Landon & Carballo-Diéguez, Alex & Stein, Zena & Ramjee, Gita & Morar, Neetha S. & Harrison, Polly F., 2005. "Microbicide acceptability research: current approaches and future directions," Social Science & Medicine, Elsevier, vol. 60(2), pages 319-330, January.
    7. Claire Marie Noël-Miller, 2003. "Concern Regarding the HIV/AIDS epidemic and Individual Childbearing," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(10), pages 319-348.

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