The researchers performed a retrospective case note review of all women who received care for HIV in pregnancy to term at their clinic.
One hundred and seven pregnancies among ninety-five women were eligible for review. Attendance for contraceptive advice within four weeks of delivery occurred in 82/107 pregnancies. Depo-Provera® was prescribed in twenty-one cases; an intrauterine contraceptive was arranged in 22/82 cases and sterilization had occurred as part of Caesarean delivery in 10/82 cases. In seven women who discontinued antiretroviral therapy at delivery one subdermal implant was fitted and the combined contraceptive pill was prescribed six times. In 17/82 cases women opted to use condoms alone. Attendance for postpartum contraceptive advice was missed following 21/107 pregnancies.
The study concluded that uptake of a second contraceptive method in addition to condoms is high among women who attend clinics for contraceptive advice in the immediate postnatal period. Twenty percent of women did not attend and their contraceptive choices remain unknown. These women are at risk of unwanted pregnancy and transmission of HIV to seronegative partners if appropriate contraceptive methods are not re-established postpartum.