Contraception among HIV-positive women in Latvia- knowledge, experience and factors influencing the choice.

Latvia has one of the highest numbers of new HIV cases in the EU. The latest SRH national survey confirmed low effective contraceptive prevalence in the general population, no data were available about women living with HIV (WLHIV). The study aimed to assess knowledge on the use of different contraceptives, to identify factors in choosing contraception, to assess the availability of family planning health care services, and to investigate contraception habits. A cross-sectional study was conducted among WLHIV aged 18-49 recruited with assistance of non-governmental organisations addressing HIV issues. Interviews in Latvian and Russian languages were based on pre-tested questionnaire. Data were processed and analysed using IBM SPSS 22.0. 102 WLHIV were interviewed and 99 of them met the inclusion criteria. Most women were aware of at least one effective contraceptive method yet around half of them had misconceptions about hormonal methods. Most of the women were able to evaluate the effectiveness of contraceptives. Sexually active women usually used male condoms (76.3%) although around 40% did not use them permanently especially if their partner was HIV-positive. Contraception usage after HIV infection decreased. Women mainly trusted medical professionals on information provided about contraceptives. Over 50% of women experienced situations they could not afford a visit to a gynaecologist or contraceptives. The survey showed a wide prevalence of misconceptions and prejudice about hormonal contraceptives. There is a need for health education including sexuality education and financial support to make effective contraception available and affordable for WLHIV.