Revista de SIDA e investigación clínica

Contraceptive use in Adolescents with Perinatally and Behaviorally Acquired Human Immunodeficiency Virus Infection Seen in a Public Los Angeles County Clinic

Abstract

Jessica Atrio, Kyle Graham, Hita Vora, Eva Operskalski and Andrea Kovacs

Objective: Primary aim is to compare contraception practices between adolescent females aged 15-25 years with perinatally vs. behaviorally acquired HIV infection

Design: A retrospective, pilot, chart review of 33 HIV positive adolescent females 15-25 years old, with one or more clinic visits at the Maternal Child and Adolescent Center for Infectious Diseases and Virology from January 1, 2010 to December 31, 2012 was conducted. Secondary outcomes included number of pregnancies, changes in contraceptive method, and condom use. Adolescents with perinatally and behaviorally acquired HIV infection were compared; and both groups were compared to the United States Centers for Disease Control national statistics.

Results: Eighteen (55%) perinatally and 15 (45%) behaviorally HIV infected adolescents were studied. Depo medroxyporgesterone Acetate (DMPA) was the most commonly used contraceptive by the perinatal group (n=7, 39%) and the second most common method in the behaviorally infected group (n=4, 27%). Condoms were the second most commonly used method among perinatally infected adolescents (n=4, 22%). Condoms in addition to a hormonal contraceptive was used by 5 (28%) perinatal and 5 (33%) of the behavioral adolescents. None of the behavioral group used condoms as the exclusive method of contraception. Long Acting Reversible Contraception (LARC) was the most commonly used method by the behavioral group (n=5, 33%). The average number of pregnancies was 2.8 (range 1-5) among adolescents with behaviorally acquired HIV and. 0.4 (range 0-2) among adolescents with perinatally acquired infection (P<0.001).

Conclusion: In this small pilot study, perinatally infected adolescents were more likely to use DMPA or condoms as compared to behaviorally infected adolescents, who were more likely to use LARC or DMPA though these differences were not statistically significant given the small sample size. Future larger studies should explore pregnancy and contraception in these distinct populations