Factors associated with contraceptive use among women living with HIV in Canada: a controlled, cross-sectional study

Abstract

Background: Multiple contraindications to combined hormonal contraceptives (CHC) use exist. The impact of these factors on contraceptive choice, particularly among women living with HIV (WLWH), is not well understood. We measured and compared the prevalence of contraceptive use and contraindications among WLWH and women not living with HIV (controls). Methods: We examined cross-sectional survey and medical chart data from 83 WLWH and 62 controls, aged 16–49 and sexually active, from 2013–2017. We compared the age-adjusted prevalence and types of contraceptives used in the last month and the proportion of women with CHC contraindications, including drug interactions, medical comorbidities, and smoking at ≥ 35 years old. All WLWH received care at an interdisciplinary, women-centred HIV clinic. Results: Compared to controls, WLWH were older (median [IQR)] 39 [34–43] vs 31 [23–41] years; p = 0.003), had less post-secondary education (37% vs 73%; p < 0.001), and more often had household income