Childbearing and contraceptive-use plans among women at high risk for HIV infection -- selected U.S. sites 1989-1991.

Childbearing and contraceptive use plans of women at high risk for HIV infection are presented. High risk was determined by past or current drug use of having had a high risk partner who was HIV positive had ever injected drugs had ever had sex with another man or had been incarcerated. Study participants (736) were drawn during 1989-91 from methadone maintenance clinics from New York (30%) and New Jersey (30%) and Philadelphia (40%); drug-free outpatient clinics from Florida (21%) New Jersey (6%) and Philadelphia (73%); and detention facilities from Florida (100%). These facilities provided antenatal and general HIV prevention reproductive health family planning and/or educational services. The age range of the nonpregnant women was 18-44 but 56% were 25-34 years and 69% were minorities. 54-60% reported no desire for children ever or within 3 years. Contraceptive use was reported as 26- 38% of women during the most recent 4 weeks of sexual activity and 37- 49% had never used contraceptives. 55-81% had intentions of using contraception during the next year but only 21-31% were actively planning on preventing pregnancy. 11-28% wanted a child within the next year. 41-64% desired a child sometime in the future. The limitations of this report are that the results are not generalizable to other settings and locations and women <25 years are not well represented. The results do however increase the understanding of decisions regarding childbearing and contraceptive use among women at risk of HIV infection. Access to high risk women may be increased by providing HIV prevention and family planning services through drug treatment centers sexually transmitted disease clinics detention facilities and shelters. Women who wish to delay childbearing should be encouraged to use contraceptives consistently and informed that condoms serve several purposes. The results identified these high risk women in 3 different settings as very similar in their pregnancy history contraceptive use plans for childbearing and plans for pregnancy prevention.