HIV and contraception: are we meeting our patients’ needs?
Awarded 2013
Complex Family Planning Fellowship Research
Natalie Ohly, MD
Columbia University

HIV specialists are the main primary care providers for women with HIV; this care often includes gynecologic care. Specific drug interactions between contraceptives and antiretroviral therapy may alter contraceptive efficacy for HIV+ women of reproductive age. There are limited data on what women with HIV are using for contraception and it is unclear what HIV specialists are recommending.
Our primary objective was to understand what providers in Upper Manhattan recommend for contraception for women with and without HIV. We also wanted to understand their patients goals and expectations for contraception.  We recruited both healthcare providers and patients to describe the landscape of contraceptive recommendations for and use by women with and without HIV who attended outpatient clinics at CUMC. From 2013- 2014, healthcare providers were recruited from the HIV and general GYN clinic at Columbia University Medical Center. They were asked to complete a survey about contraceptive recommendation for their patients that also assessed knowledge and resource utilization regarding HIV medication and contraceptive interactions. We found that Most HIV + women of reproductive age use ART, HIV providers see more women with HIV compared to the general GYN providers, HIV providers prescribe less contraception than their GYN provider counterparts and were more unfamiliar with CDC MEC, and that gynecology providers are more cautious to prescribe contraception for women with HIV.