Postpartum LARC discontinuation and short interval pregnancies among women with HIV: a retrospective nine-year cohort study in South Carolina

Abstract Objectives To evaluate rates of discontinuation and short interval pregnancy among women with HIV who received a postpartum IUD or implant. Methods We conducted a retrospective cohort study of women who had an IUD or implant placed within 3 months postpartum during a nine-year period (1/1/09 to 2/14/18). We assessed the prevalence of discontinuation within 12 months and rates of subsequent delivery within 18 months. We examined differences in these outcomes between women with and without HIV. Results Of the 794 women who received a long-acting reversible contraception (LARC) within 3 months postpartum, most chose an IUD (85%). Twenty-one percent (165) elected for immediate postpartum placement: 119 IUDs and 46 implants. Women with HIV were more likely to receive an implant (48% vs 13%, p p Conclusions Women with HIV in South Carolina were more likely than HIV negative women to receive immediate postpartum LARC and to receive an implant. They were not more likely to discontinue LARC within 12 months nor experience short interval pregnancies. Implications. Further study is needed to evaluate preferences for implants and immediate postpartum insertion among women with HIV.