Contraception Method Type by Self-Reported HIV Status among Women in Malawi

Honorable Mention, Denman Undergraduate Research Forum 2016SOLAR Foundation Undergraduate Research Award, 2015-2016Objectives: This analysis aims to determine 1) which methods of contraception are used by women in Malawi; 2) whether the methods differ by self-reported HIV status; and 3) whether frequency of condom use at last sex differs by self-reported HIV status. Methods: The analysis is based on 13,618 non-pregnant women aged 15-49 in the 2010 Malawi Demographic and Health Survey who had sexual debut and reported the result of their last HIV test. We accounted for the 2-stage cluster sampling design by applying cluster, stratum, and sample weights. Current contraceptive method analysis was restricted to the subgroup with contraceptive need (i.e., fecund women who did not want a pregnancy in next 12 months). Differences in use between HIV-positive and HIV-negative women were assessed with chi-squared tests of significance. Results: The proportion reporting condom use at last sex was statistically significantly higher in HIV-positive women (34.5%, standard error (s.e.)=2.2) than HIV-negative women (8.5%, s.e.=2.2, p<.01). Among women with contraceptive need (N=12,658; 93.1%), use of long-acting reversible contraception (LARC) was low and did not differ between HIV-positive (1.4%, s.e.=0.44) and HIV-negative women (1.9%, s.e.=0.19, p=0.35). HIV-negative women (30.4%, s.e.=0.64) were more likely than HIV-positive women (15.6%, s.e.=1.4, p<.01) to use progestin-only injections. Utilization of female sterilization was higher in HIV-positive women (17.9%, s.e.=1.8) than in HIV-negative women (9.2%, s.e.=0.38, p<.01). Conclusions: LARC use was low among women in Malawi. Female sterilization was higher than in many other countries in sub-Saharan Africa. Targeted interventions to promote contraception are urgently needed to prevent mother-to-child transmission of HIV in Malawi.SOLAR Foundation Research Fund (Undergraduate Research Office, Board of Trustees of The Ohio State University, SOLAR Foundation: Morristown, NJ)No embargoAcademic Major: Public Healt