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Preventing Unplanned Pregnancies in HIV Infected Zambian Couples

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00067522
Recruitment Status : Unknown
Verified September 2005 by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Recruitment status was:  Active, not recruiting
First Posted : August 25, 2003
Last Update Posted : June 29, 2007
Information provided by:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Brief Summary:
Prevention of unplanned pregnancies among HIV infected couples decreases the rate of maternal-child virus transmission and the number of children orphaned when parents die of AIDS. This study will evaluate two programs for reducing the number of unplanned pregnancies among HIV infected couples in Zambia.

Condition or disease Intervention/treatment Phase
Pregnancy HIV Infections Behavioral: User-independent contraception program Behavioral: Future Planning Perspectives program Not Applicable

Detailed Description:

Eighty percent of the world's HIV infections are in sub-Saharan Africa. In Lusaka, the capital of Zambia, 85% of pregnant women are married and 47% are in couples with at least one HIV infected partner (26% concordant positive, 21% discordant). It will be years before short-course antivirals are widely implemented, and many children who escape infection will be left orphaned. There are 360,000 AIDS orphans in Zambia, a country of 9 million people, and 35,000 HIV infected women deliver each year.

An essential component of any HIV prevention strategy must include the prevention of unplanned pregnancies among couples with HIV. Promotion of 'dual method' contraception (condoms for HIV/STD prevention plus a longer acting method for pregnancy prevention) is ideal, but unfortunately not widely promoted. Ultimately, the prevention of unplanned pregnancy in couples with HIV can reduce pediatric HIV, AIDS orphans, and the family consequences of parental illness and death.

This study will evaluate two interventions aimed at reducing the incidence of unplanned pregnancies in HIV infected couples. The first intervention will promote more effective contraception by placing user-independent methods (IUD and Norplant) first in the educational message hierarchy (currently, family planning education highlights oral contraceptives) and employing positive message framing. The second intervention will help couples plan for the consequences of their illness and death. This will include assisting couples to work together to prepare a will, choose a guardian, and make a financial plan. By focusing on the cost of educating existing children and on the need to plan for their future care, couples are encouraged to reflect on the implications of future childbearing. The interventions will be compared with a standard family planning program with respect to impact on incident pregnancy, contraceptive choice and pattern of use, psychosocial and behavioral variables, and future planning actions. Cost-effectiveness will be determined with methods developed jointly by experts in the fields of HIV therapy in Africa and contraception.

Participants in this study will be randomized to either the user-independent contraception intervention, the future planning intervention, the contraception plus planning intervention, or the standard family planning control. Couples will be followed for 1 to 4 years. Women will have study visits every 3 months; men will have a study visit every year. The primary study outcome will be comparison of time to pregnancy across intervention groups.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 5000 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single
Primary Purpose: Prevention
Official Title: Family Planning Promotion to Prevent Unplanned Pregnancies in HIV Infected Zambian Couples
Study Start Date : January 2002

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. pregnancy

Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years to 38 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  • Couples with one or both partners with HIV infection

Exclusion Criteria

  • Pregnant or < 1 month post-partum (couples will be invited to return when the infant is > 1 month old)
  • Peri- or post-menopausal
  • Surgical sterilization or hysterectomy
  • Documented infertility

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00067522

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Zambia Emory HIV Research Project
Lusaka, Zambia
Sponsors and Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
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Principal Investigator: Susan Allen, MD, MPH Emory University, Rollins School of Public Health
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00067522    
Other Study ID Numbers: HD40125
1R01HD040125-01A1 ( U.S. NIH Grant/Contract )
First Posted: August 25, 2003    Key Record Dates
Last Update Posted: June 29, 2007
Last Verified: September 2005
Keywords provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):
Family Planning
Sexually Transmitted Diseases
HIV Prevention
Additional relevant MeSH terms:
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HIV Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases