AFISE Family Planning needs among women at COE

Family Planning needs among women at the Baylor Clinical Centre of Excellence (COE) in Constanta, Romania Violeta Cîndea, Ana-Maria Schweitzer, Ștefania Florentina Mihale, and Rodica Mihai Baylor Black Sea Foundation, Constanta, Romania Background More than 80% of the 850 Baylor COE patients are young adults, sexually active, engaged in both HIV sero-con- cordant and sero-discordant relationships. Within the last 3-4 years we noticed a rising trend of repeated abor- tions and multiparity among HIV positive women. A baseline assessment was set up in order to identify the unmet needs, and to design a Family Planning program for our clients. Methods We used an assessment tool to collect data from a total of 175 women, from which 94% were HIV positive and 6% were HIV negative. The specific collected data were: obstetrical history (number of pregnancies, births, abortions, children alive); fertility intentions (delaying, spacing, limiting, uncertain, want a pregnancy, pregnant); partner’s HIV status (positive, negative, unknown, no partner), condom use, other contraceptive methods use. Women wanting to get pregnant anytime 13% Results Avoiding pregnancies is an important issue for our pa- tients: from 175 women, 87% want to avoid a pregnancy (35% delay, 18% space, and 34% limit needs). Half of them report condom use as dual protection, but abortion is common among them: 26% of women had at least one such event in their obstetrical history. From 11 HIV negative women in sero-discordant couple, 6 women were nulligravida and 5 women using condom as double protection had already 8 deliveries and 9 abor- tions. Among 76 HIV positive women in sero-discordant couples wanting to space, almost 80% reported condom use and almost 60% have already had an abortion. Far- ther more, from those wanting to limit pregnancies, only 40% were using a long acting and very efficient contra- ceptive method (i.e. 30% tubal ligation, and 10% IUD), 35% reported condom use, and 25% were using fertility awareness methods (mainly withdrawal), and 50% from all of them had at least one abortion (average 2.3). NO YES/Don't know 87% Contraceptive use by 152 women who don't  want to get pregnant 3% 18% IUD 50% 1% 14% condoms 11% tubal ligation COC FAM 3% none without patner Women using condoms and experiencing at least  one abortion 26% NO 74% Conclusions YES There are unmet Family Planning needs among our target group. Using condoms helps prevent HIV transmis- sion, most likely corroborated with ARV adherence and other possible factors, but it is less efficient in preg- nancy prevention among our cohort. For HIV infected persons who want to delay, space or limit pregnancies, using condoms simultaneously with an efficient contraceptive method will ensure dual protection for HIV transmission and pregnancy preven- tion. Our Family Planning program needs to be built on three pillars: ensuring a diversified range of free of charge modern contraceptives, FP counseling provided by trained staff, and BCC (behavior change communication) activities promoting the new FP services and dual method use among our beneficiaries. PRESENTED AT THE 21ST INTERNATIONAL AIDS CONFERENCE - DURBAN, SOUTH AFRICA