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Infectious Diseases in Obstetrics and Gynecology
Volume 2017, Article ID 1475813, 9 pages
Research Article

Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study

1UNC Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
2UNC Department of Obstetrics & Gynecology, 101 Manning Drive, Chapel Hill, NC 27514, USA
3UNC Department of Epidemiology, 135 Dauer Drive, Chapel Hill, NC 27599, USA
4Division of Epidemiology, Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA
5UNC Department of Medicine, 125 MacNider Hall, Chapel Hill, NC 27599, USA
6Department of Obstetrics & Gynaecology, Malawi College of Medicine, Private Bag 360, Chichiri, Blantyre, Malawi
7Bwaila Hospital, Lilongwe District Health Office, Lilongwe, Malawi

Correspondence should be addressed to Dawn M. Kopp; moc.liamg@ppok.m.nwad

Received 22 March 2017; Accepted 4 June 2017; Published 18 July 2017

Academic Editor: Ann Duerr

Copyright © 2017 Dawn M. Kopp et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended pregnancy and HIV infection. We evaluated the association of HIV status with dual method use in a cohort of postpartum women. Women completed baseline surveys in the postpartum ward and telephone surveys about contraceptive use 3, 6, and 12 months later. Nonpregnant women who completed at least one follow-up survey were eligible for this secondary analysis. Prevalence ratios were calculated using generalized estimating equations. Of the 511 sexually active women who completed a follow-up survey, condom use increased from 17.6% to 27.7% and nonbarrier contraceptive use increased from 73.8% to 87.6% from 3 to 12 months after delivery. Dual method use increased from 1.0% to 18.9% at 3 to 12 months after delivery. Dual method use was negligible and comparable between HIV-infected and HIV-uninfected women at 3 months but significantly higher among HIV-infected women at 6 months (APR = 3.9, 95% CI 2.2, 7.1) and 12 months (APR = 2.7, 95% CI 1.7, 4.3). Dual method use was low but largely driven by condom use among HIV-infected women at 6 and 12 months after delivery.