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Lisa Haddad, MD, MS

Contraceptive eligibility, choice and acceptance of the copper IUD among HIV+ women at an ART clinic in Lilongwe, Malawi. Lisa Haddad, MD, MS. Acknowledgements. Sam Phiri Caryl Feldacker Hannock Tweya Carrie Cwiak Denise J. Jamieson Mina Hosseinipour Irving Hoffman Amy G. Bryant

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Lisa Haddad, MD, MS

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  1. Contraceptive eligibility, choice and acceptance of the copper IUD among HIV+ women at an ART clinic in Lilongwe, Malawi Lisa Haddad, MD, MS

  2. Acknowledgements Sam Phiri Caryl Feldacker Hannock Tweya Carrie Cwiak Denise J. Jamieson Mina Hosseinipour Irving Hoffman Amy G. Bryant Gretchen S. Stuart Isaac Noah Linly Mulundila Bernadette Samala Mike Nyirenda

  3. Critical need for contraception Unintended pregnancy

  4. Need dual protection strategies

  5. Study Location • Malawi • Capital: Lilongwe • 14 million people • 12% HIV prevalence • 42% use modern contraceptive* • 62% DMPA, <1% IUD • Lighthouse clinic • >18,000 HIV+ clients/yr • >15,000 alive on ART • ≅110 women 18-45/day • Only condoms available * MDHS-2010

  6. Methods

  7. Objectives • Assess contraceptive medical eligibility • Assess contraceptive method choice • Assess the acceptance for IUD insertion

  8. Study preparation/initiation

  9. Results- Medical eligibility

  10. Results- Medical eligibility

  11. First Choice Method 58% 6%

  12. Consider an IUD? 79% 49% 37% 21% 14%

  13. Reasons for declining IUD

  14. Special considerations • Results for choice may be specific to this community • Counseling and provider motivation may play a role in client method choice • Contraceptive implant was available by referral-only • Medical eligibility criteria may change over time

  15. Conclusion • Most methods of contraception were safe for women in this setting • Many would choose an IUD if available after counseling • Almost 80% of the women were willing to receive an IUD • Efforts must be made to increase access to and uptake of long-acting reversible methods, such as IUDs.

  16. Next steps • Explore factors related to method choice • Evaluate IUD acceptability over time • Explore factors related to method adherence • Continue to expand reproductive health services at Lighthouse

  17. Zikomo

  18. QUESTIONS??

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