Contraceptive needs of human immunodeficiency virus-positive adolescent women compared with a human immunodeficiency virus-negative cohort.

INTRODUCTION: Adolescents and young adults disproportionately acquire new human immunodeficiency virus (HIV) infections in the United States. Little is known about how contraceptive practices differ between HIV-infected and -noninfected young women. METHODS: We conducted a cross-sectional survey of young HIV-infected and -uninfected women between the ages of 13 and 21 years. Participants provided demographic information sexual and reproductive health history and contraceptive use patterns. Differences were examined using nonparametric (chi) and parametric (t tests) tests as appropriate. RESULTS: Twenty-eight HIV-infected and 96 HIV-uninfected women completed the survey. The two groups were demographically similar except there were more African Americans among the HIV-positive group (82% compared with 53% P=.04). Eighty-eight percent of all respondents reported a history of intercourse and 27% had ever been pregnant; proportions were not different between groups. Human immunodeficiency virus-infected women were less likely to have used health care provider-prescribed contraceptives (ie birth control pills) at last intercourse compared with their HIV-negative peers (odds ratio [OR] 0.28 95% confidence interval [CI] 0.11-0.74) and they were more likely to have relied on condoms alone (75% compared with 29% P=.005). Few respondents (16% of total) had used long-acting reversible contraceptives. Use of dual contraception was lower in HIV-positive women although this was not statistically significant (OR 0.58 95% CI 0.17-2.03). CONCLUSIONS: When compared with HIV-negative young women HIV-positive young women are less likely to use a prescribed contraceptive and are significantly more likely to rely on condoms. Although condom use is critical for prevention of HIV transmission it is important to ensure that HIV-positive youth have access to highly effective contraceptives.