Contraceptive use among post-partum HIV positive women in lilongwe, Malawi

Objectives: To determine prevalence and types of contraceptive method use and examine change in self-reported current use of contraceptive methods from first to last visit among a group of post-partum HIV-positive women enrolled in a post-natal program. Methods: From October 2008 to August 2009, HIV-positive women between six to 18 months post-delivery participated in a post-natal program in Lilongwe, Malawi. Participants completed a questionnaire on contraceptive use and maternal and infant health status and then, received education and counseling regarding family planning (i.e., contraceptive use). Enrolled women were scheduled for one follow-up visit per month for up to six months. Results: At the time of their initial study visit, contraceptive use was more than two times higher among post-natal program participants than among women in the Malawian general population (83% vs. 35.4%, respectively). While enrolled in the post-natal program, the majority of women (82%) maintained their current use of any contraceptive method. Approximately 5% of women not previously using any contraceptive method began using any contraceptive method and approximately 1% ended their use of any contraceptive method during the study period. The majority (71.4%) of women who started use of any contraceptive method began to use injectables, followed by bilateral tubal ligation (19.5%), and equal proportions of women using condoms or oral contraceptives (4.8%). Conclusion: Established post-natal programs can be effectively leveraged to deliver family planning messages. These programs can be utilized to encourage all women and especially, HIV-positive women, to start and maintain a family planning regimen.