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Partners' serostatus sways condom use in HIV-infected women
  By David Douglas
NEW YORK (Reuters Health) - A survey of HIV-infected women in France with steady male partners indicates a high overall use of contraceptives. However, serodiscordant couples are much more likely to consistently use condoms than are seroconcordant couples.
In the June 1st issue of the Journal of Acquired Immunodeficiency Syndromes, Dr. Isabelle Heard of Hopital Europeen Georges Pompidou, Paris and colleagues report on their observational study of contraceptive use in 575 sexually active women over a period of about 9 years. The women were interviewed semiannually.
Their median age was 32 years, 62% were white, 30% were black African or Caribbean and the remainder were from various ethnic backgrounds. Most (73%) had been infected through heterosexual contact or injection drug use (23%).
There were 429 reports of a relationship with an HIV-negative partner and 190 with a HIV-positive partner.
Contraceptive use was reported at 91% of survey points by women with a seronegative partner and 69% of those with a seropositive partner.
Condom use was 6.1 times less likely in women with a seropositive partner than in those with a seronegative partner. Conversely, use of intrauterine devices and oral contraception was 2.1 times higher in seroconcordant couples than in serodiscordant couples.
However, even after introduction of highly active antiretroviral therapy, the level of condom use remained stable among both sets of couples. This suggests, say the investigators, that "the decrease in HIV viral load did not impact on sexual behavior."
Dr. Heard told Reuters Health that emphasis should be placed on the provision of "family planning services for HIV-positive women" particularly to "help them in choosing available contraception according to their specific need."
J Acquir Immune Defic Syndr 2004;156:714-720.


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