CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Male partner participation and achieving viral suppression are major barriers to safe conception. Even though many couples do not wait to conceive until both partners were virally suppressed, use of safer conception strategies reduced risks by lowering viral load and limiting unprotected sex among those conceiving prematurely.

896 Preventing Unintended Pregnancy and HIV: The HIV Treatment Cascade and Contraceptive Choices Julia Raifman 1 ;Terusha Chetty 2 ; FrankTanser 2 ;Tinofa Mutevedzi 2 ; Philippa Matthews 2 ; Kobus Herbst 2 ; Deenan Pillay 2 ;Till Barnighausen 1 1 Harvard School of Public Health, Washington, DC, US; 2 Africa Centre for Health and Population Studies, Mtubatuba, South Africa

Background: Contraception using condoms is recommended for women living with HIV because it prevents unintended pregnancy, acquisition of other sexually transmitted diseases, and onward transmission of HIV. Dual-method dual protection contraception (condoms with other methods) has greater contraceptive effectiveness than single-method dual protection contraception (condoms alone) and is also preferable to single protection (non-condommethods), which only protect against unintended pregnancy without preventing HIV and other STI transmission. We estimate the effect of progression along the HIV treatment cascade on contraceptive use and choice among HIV-infected women in a high prevalence rural South African setting. Methods: We linked population-based surveillance data on contraception collected by the Wellcome Trust-funded Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa sub-district, KwaZulu-Natal. We estimated a bivariate probit model of the effects of progressing through the cascade on contraceptive choice among HIV-infected, sexually active women aged 15-49 years (N=3169), controlling for potential confounders based on individual and household characteristics. Results: Overall contraception use increased across the cascade from<40% among HIV-infected women who did not know their status to >70% among women on ART for 4-7 years. Table 1 shows the average marginal effects of movement through the treatment cascade on contraceptive choice. We found that becoming aware of HIV-positive status increased the probability of women using single-method dual protection by 4.6 percentage points (pp, p=0.030) and the probability of using dual-method dual protection by 3.5 pp (p=0.001) relative to women who were unaware of their HIV-positive status. Being on ART for less than a year increased the probability of using single-method dual protection by 10.3 pp (p=0.003) and the probability of dual-method dual protection by 5.2 pp (p=0.007), while being on ART for 4-7 years increased the probability of using single-method dual protection by 21.6 pp (p<0.001) and dual-method dual protection by 11.2 pp (p<0.001).

Poster Abstracts

Conclusions: We conclude that progression along the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. HIV counseling and treatment programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice.

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CROI 2015