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