There is limited information on the patterns and trends of contraceptive use among women living with HIV, compared with noninfected women in the United States. Further, little is known about whether antiretroviral therapy correlates with contraceptive use. Such information is needed to help identify potential gaps in care and to enhance unintended pregnancy prevention efforts.
To compare contraceptive method use among HIV-infected and noninfected privately-insured women in the United States. To evaluate the association between antiretroviral therapy use and contraceptive method use.
We used a large United States nationwide healthcare claims database to identify women ages 15-44 years who had coverage for prescription drugs. We used diagnosis, procedure, and national drug codes to assess female sterilization and reversible prescription contraception use in 2008 and 2014 among women continuously enrolled in the database during 2003-2008 or 2009-2014, respectively. Women with no codes were classified as using no method; these may have included women using non-prescription methods, such as condoms. We calculated prevalence of contraceptive use by HIV infection status, and by use of antiretroviral therapy among those with HIV. We used multivariable polytomous logistic regression to calculate unadjusted and adjusted odds ratios and 95% confidence intervals for female sterilization, long acting reversible contraception and short-acting hormonal contraception compared to no method.
While contraceptive use increased among HIV-infected and noninfected women from 2008 to 2014, in both years, a lower proportion of HIV-infected women used prescription contraceptive methods (2008: 17.5%; 2014: 28.9% , compared with noninfected women (2008: 28.8%; 2014: 39.8%, p<0.001 for both). Controlling for demographics, chronic medical conditions, pregnancy history and cohort year, HIV-infected women compared to HIV noninfected women had lower odds of using long-acting reversible contraception (adjusted odds ratio 0.67; 95% confidence interval 0.52-0.86 compared to no method) or short-acting hormonal contraception method (adjusted odds ratio 0.59; 95% confidence interval 0.50-0.70 compared to no method). In 2014, HIV-infected women using antiretroviral therapy were significantly more likely to use no method (76.8% versus 64.1%), and significantly less likely to use short-acting hormonal contraception (11.0% versus 22.7%), compared to HIV-infected women not using antiretroviral therapy. Those receiving antiretroviral therapy had lower odds of using short-acting hormonal contraception compared to no method (adjusted odds ratio 0.45; 95% confidence interval 0.32-0.63). There was no significant difference in female sterilization by HIV status or antiretroviral therapy use.
Despite the safety of reversible contraceptives for women with HIV, use of prescription contraception continues to be lower among privately-insured HIV-infected women compared to noninfected women, particularly among those receiving antiretroviral therapy.
Pharmacology, Toxicology and Pharmaceutical Science
2
4%
Unspecified
1
2%
Business, Management and Accounting
1
2%
Other
4
8%
Unknown
24
49%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2023.
All research outputs
#3,654,004
of 34,404,538 outputs
Outputs from American Journal of Obstetrics & Gynecology
#3,703
of 17,475 outputs
Outputs of similar age
#50,027
of 355,444 outputs
Outputs of similar age from American Journal of Obstetrics & Gynecology
#47
of 78 outputs
Altmetric has tracked 34,404,538 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 17,475 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.0. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 355,444 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 78 others from the same source and published within six weeks on either side of this one. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.
