Resumption of sexual activity and regular menses after childbirth among women infected with HIV in Malawi

Makanani, Bonus; Kumwenda, Johnstone; Kumwenda, Newton; Shu, Chang; Tsui, Amy O.; Taha, Taha E.

doi:10.1016/j.ijgo.2009.08.014

Cited by 14 publications

(18 citation statements)

References 22 publications

(25 reference statements)

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“…Qualitatively, women reported that sexual activity should cease between the 6 th and 8 th month of pregnancy and not resume until 6 months postpartum. This corroborates with a recent study about postpartum abstinence in Malawi reporting that the median time to resumption of sexual activity after childbirth was between 7 and 9 months [20]. In our study, reports of spouse’s risky behavior did not differ between groups.…”

Section: Discussionsupporting

confidence: 93%

High HIV Incidence and Sexual Behavior Change among Pregnant Women in Lilongwe, Malawi: Implications for the Risk of HIV Acquisition

Keating

Hamela²,

Miller

et al. 2012

PLoS ONE

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Background HIV incidence is higher among pregnant women than their non-pregnant counterparts in some sub-Saharan African settings. Our aims were (1) to estimate HIV incidence during pregnancy and (2) to compare sexual activity between pregnant, postpartum, and non-pregnant women. Methods We examined a retrospective cohort of 1087 women to identify seroconverters using antenatal and labor ward HIV test results. We also conducted a cross-sectional survey, including a quantitative questionnaire (n = 200) and in-depth interviews (n = 20) among women in early pregnancy, late pregnancy, postpartum, and non-pregnancy. Outcomes included measures of sexual activity, reported spouse’s risky behavior, and beliefs about abstinence. Results 11 of 1087 women seroconverted during pregnancy yielding a 1% seroconversion risk and an incidence rate of 4.0/100 person years (95% CI 2.2–7.2). The reported sexual activity of the early pregnancy and non-pregnancy groups was similar, but significantly higher than the late pregnancy and postpartum groups (p<0.001). During pregnancy, sex acts decreased as gestation increased (p = 0.001). There was no reported difference in the spouse’s risky behavior. Most women believed that sex should cease between the 6 th and 8 th month of pregnancy and should not resume until 6 months postpartum. Some talked about conflict between their cultural obligation to abstain and fear of HIV infection if their spouses find other partners. Conclusions HIV incidence is high among pregnant women in Malawi, and sexual activity decreases during pregnancy and postpartum. Pregnant women need to be informed of their increased risk for HIV and the importance of using condoms throughout pregnancy and the postpartum period.

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Section: Discussionsupporting

confidence: 93%

High HIV Incidence and Sexual Behavior Change among Pregnant Women in Lilongwe, Malawi: Implications for the Risk of HIV Acquisition

Keating

Hamela²,

Miller

et al. 2012

PLoS ONE

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“…Recent studies from Nigeria report earlier resumption of coitus after delivery 15,24 . We found that older married women reported earlier resumption of sex, consistent with other studies 15,46-48 . In our study, women with caesarean deliveries resumed sex earlier compared to those delivered vaginally.…”

Section: Discussionsupporting

confidence: 92%

Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies

Kinuthia

Richardson

Drake

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. Methods HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Results Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner and 33.6% partner of unknown HIV status. At enrollment, 58.5% reported sex in past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married compared to unmarried women (p<0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared to HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (IQR 4-12). Prevalence of unprotected sex in past week increased from 6.6% to 60.0% between 2 to 36 weeks postpartum (p<0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (p<0.001). Vaginal washing and drying were associated with forced sex. Conclusion High rates of unknown partner HIV status, polygamy, and low condom use among pregnant/postpartum women underscores need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

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“…E-mail: anyi_ ezebialu@yahoo.com with dyspareunia (Signorello et al 2001). A study of HIV-positive women in Malawi indicated that resumption of coitus is dependent on certain sociodemographic characteristics such as marital status and use of contraceptives (Makanani et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Resumption of vaginal intercourse in the early postpartum period: Determinants and considerations for child spacing in a Nigerian population

Ezebialu

Eke

2012

Journal of Obstetrics and Gynaecology

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A total of 860 mothers were interviewed during their first postnatal clinic visit to determine the factors that influenced their resumption of sexual intercourse as well as their family planning practices in the early postpartum period. Some 255 (29.7%) women had resumed sexual intercourse with a mean delivery - resumption interval of 5.4 ± 2.6 weeks. Resumption of menses and HIV-negative status were the factors most significantly associated with resumption of sexual intercourse. Other significant determinants were urban residence and vaginal delivery without tears. Only 21.5% of the sexually active mothers used a modern contraceptive in the form of a male condom, while 56.9% did not consider contraception at all. The major reason for prolonged abstinence was fear of another pregnancy. In this group of women, child spacing appears to be the major consideration for resumption of coitus, even over the fear of painful discomfort.

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Resumption of sexual activity and regular menses after childbirth among women infected with HIV in Malawi

Abstract: HIV-infected women need adequate counseling to take into account their HIV infection status before resuming sexual activity after childbirth.

Cited by 14 publications

References 22 publications

High HIV Incidence and Sexual Behavior Change among Pregnant Women in Lilongwe, Malawi: Implications for the Risk of HIV Acquisition

High HIV Incidence and Sexual Behavior Change among Pregnant Women in Lilongwe, Malawi: Implications for the Risk of HIV Acquisition

Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies

Resumption of vaginal intercourse in the early postpartum period: Determinants and considerations for child spacing in a Nigerian population

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