This study uses Demographic and Health Survey (DHS) data to investigate how receipt of HIV test results influences subsequent contraceptive behavior. In five countries (Kenya, Lesotho, Malawi, Zambia, and Zimbabwe), we analyze the effect of HIV testing during antenatal care on adoption of contraception following birth. In two of the countries (Lesotho and Zimbabwe), we also examine (a) adoption and (b) discontinuation of contraception among women who did not experience a birth in the past 24 months and for whom the option of an HIV test occurs outside of the context of antenatal care. We use longitudinal contraceptive calendar data to estimate hazard models of a change in contraceptive behavior, using as covariates (1) HIV status as determined by biomarker testing at the time of the survey and (2) women’s self-reported HIV testing experience.
In Kenya only, HIV-positive women have a longer duration to adopting contraception following birth compared with HIV-negative women. This relationship is not found elsewhere, nor is HIV status associated with the hazard of adopting or discontinuing contraception among women without a birth in the past 24 months.
In Lesotho, Zambia, and Zimbabwe, women who receive HIV test results during antenatal care have a shorter expected time to adopting contraception, regardless of HIV status, but not in Kenya or Malawi. Among women without a birth in the past 24 months, those who receive HIV test results have a shorter expected time to adopting contraception in Zimbabwe, but there is no statistical difference in Lesotho. Experience with HIV testing does not influence discontinuation of contraception.