Background Little is well known about the impact of knowledge of HIV serostatus on pregnancy intention and contraceptive use in high-HIV-burden southern African settings in the era of widespread antiretroviral treatment availability. child die before the age of 5?years (P?0.0001). Discussion This is the first published data on unintended pregnancy, contraceptive use and HIV serostatus in Botswana, a country where 30.4?% of women of reproductive age are HIV-infected [13]. We found that both contraceptive failure (or misuse) and unmet need for family planning may have contributed to the high levels of 122647-32-9 IC50 unintended pregnancies among both HIV-infected and HIV-uninfected women, similar to findings from other recent studies in sub-Saharan Africa [10, 18]. Overall, 44?% of women from two areas of Botswana reported that their pregnancy was unintended. The Botswana 2013 Global AIDS Response Report estimated levels of unplanned pregnancy at 50?% [19]. Factors associated with unintended pregnancy in our study were similar to those found in other studies in sub-Saharan Africa [10, 20]. Reported contraceptive use prior to unintended pregnancy was high (64?%), but the methods used were exclusively short-acting requiring daily (OC), quarterly adherence (DMPA), or with every act of sexual intercourse (male condom). The vast majority of women with an unintended pregnancy (81?%), regardless of HIV serostatus, reported relying on the male condom for contraception. Our findings suggest that reliance on condoms for pregnancy prevention is not an effective strategy. This is supported by recent studies in areas of high HIV prevalence, which have shown that more effective methods of contraception are substituted for male condom-only use [20C22]. Women and couples should be informed that while male condoms are the only contraceptive method that can reduce the risk of sexually transmitted infections including HIV and that their correct and consistent use is imperative in that regard, they may have a high failure rate for pregnancy prevention. 122647-32-9 IC50 This is likely due to low FANCC levels of correct and consistent use, with a typical-use contraceptive failure rate for the male 122647-32-9 IC50 condom of about 21?% within the first 12 months [23]. Ideally in the context of high levels of HIV contamination, a dual method approach (i actually.e., merging condoms, female or male, with an efficient contraceptive technique) ought to be marketed [4]. Our data high light the urgent dependence on womens usage of effective contraceptive strategies that align with being pregnant intentions and decrease the potential for wrong or inconsistent make use of. LARCs like the intrauterine gadget (IUD) as well as the contraceptive implant decrease or get rid of the dependence on daily or per-act of intercourse adherence. The IUD isn’t supplied in Botswanas open public wellness sector often, with its make use of among females aged 12C49 having peaked at 4.1?% in the later 1980s and declining since to about 0.8?% in 2007, because of now disproved protection worries about IUD make use of in the framework of HIV [24]. Sterilization hasn’t been practiced in Botswana (utilized among <2 widely?% of females aged 12C49 from 1985 to 2007) [24]. Thankfully, the Botswana Intimate and Reproductive Wellness Department has prioritized raising the way to obtain and demand for the LARC strategies (personal communication, Reproductive and Intimate Wellness Department, Botswana Ministry of Wellness). Further goals of our research had been to examine heterogeneity in unintended being pregnant, contraceptive upcoming and use childbearing desires by HIV serostatus. We discovered that 26?% of HIV-infected females reported being unsure of their HIV position ahead of conception. Although it can be done that a few of these females did actually know that these were HIV-infected but weren't comfy disclosing this during research enrollment, this may suggest also.