Use of effective contraception among sexually active HIV positive women in Latvia

The fertility of women living with HIV (WLHIV) is not significantly different from healthy women in childbearing age, and most WLHIV are sexually active. The choice of contraception among WLHIV has not been sufficiently studied in Latvia. The study aims to assess the prevalence of contraceptive use and method preference among sexually active WLHIV in Latvia. This study was conducted in cooperation with the European Society of Contraception and Reproductive Health. A cross-sectional survey of sexually active WLHIV aged 18 to 49 years, took place in nongovernmental organization's (AGIHAS, DIA+LOGS) from March 2019 until October 2020. Research tool: anonymous questionnaire. Data was processed with IBM SPSS statistics. From 102 responders, 79 were sexually active WLHIV, 86.1% of them used contraception. Most used contraception was condoms (89.7%). Only 59% reported using condoms during each sexual intercourse. Among condom users, 62.3% reported condoms as their only method of contraception. However, one third of these women were not using condoms during each sexual intercourse. The second most used method was pills (17.6%). 23.5% recognized the use of natural contraceptive methods (calendar method, douching, coitus interruptus). In 56.9% of all cases, women were responsible for contraception. 51% of women reported financial difficulties in purchasing contraceptives. No significant association was noted between contraceptive use and other sociodemographic factors (age, education, marital status, partners HIV status, parity). There is a high level of contraceptive use among sexually active WLHIV in Latvia. However, every fifth WLHIV use contraception with low effectiveness and there is a high rate of condom users who do not use this method permanently. Many WLHIV in Latvia face financial difficulties in obtaining contraception. There is a need for health education and financial support to make effective contraception available and affordable and decrease the risk of unintended pregnancies for WLHIV.