Effect of behavioral interventions on contraceptive use among women living with HIV: Systematic review and meta-analysis of randomized controlled trials.

Michael Deynu, Jerry John Ouner, Sarah A Gutin, Ifeyinwa V Asiodu, Peggy Tahir, Glenn-Milo Santos

Abstract readSystematic ReviewMeta-Analysis

In one paragraph

Synthesis in Reproductive health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael DeynuDepartment of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, 94158, USA. michael.deynu@ucsf.edu.

Jerry John OunerDepartment of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, 94158, USA.

Sarah A GutinDepartment of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, 94158, USA.

Ifeyinwa V AsioduDepartment of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, 94158, USA.

Peggy TahirUniversity of California San Francisco Library, University of California San Francisco, San Fracisco, CA, 94143, USA.

Glenn-Milo SantosDepartment of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, 94158, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContraceptive use is a cost-effective public health strategy to prevent unplanned pregnancy, maternal mortality and morbidity, and reduce vertical HIV transmission. However, contraceptive use remains low among women living with HIV. Reviews examining effect of behavioral interventions on contraceptive use among women living with HIV using randomized controlled trials are limited. We evaluated the effect of behavioral interventions on contraceptive use among women living with HIV using randomized controlled trials.

methodsWe conducted a systematic literature search across PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov and the Cochrane Central Register of Control Trials from their inception to 09/15/2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-2020) guidelines were followed in conducting this review. Peer reviewed and published randomized controlled trials (RCTs) focusing on behavioral interventions were included. Effect estimates (odds ratios) were pooled using a random-effects model (REM). Quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

resultsThe search yielded 853 records. Five trials involving 5903 women living with HIV and published between 2009 and 2021 were included in this review. Across the trials, structured contraceptive counseling was the most common intervention implemented while others included provision of family planning vouchers, client outreaches and education and counseling on safe sex, and social support. Two of the studies were conducted in Uganda, two in Kenya and one in the United States. Two of the studies reported 100% antiretroviral therapy use with mean duration ranging 4.1 years (SD = 3.33) to 7.8 years (SD = 7.1), while one study reported 83.9% viral suppression among their sample. Across the trials, behavioral interventions were significantly associated with greater odds of contraceptive use among women living with HIV with pooled odds ratio, 3.61 (95% CI: 1.15, 11.32), p = 0.04 compared to controls.

conclusionsThe findings underscore the efficacy of behavioral interventions in enhancing contraceptive use among women living with HIV. Leveraging behavioral interventions could offer an opportunity to increase contraceptive use and improve the reproductive health outcomes for women living with HIV.

Indexed as

Contraception BehaviorHIV InfectionsAdherence InterventionsCounselingFamily Planning ServicesFemaleHumansPregnancyRandomized Controlled Trials as TopicBehavioral interventionsContraceptionCounselingHIVMeta-analysisSystematic reviewUnplanned pregnancy

Identifiers

PMID42343446

DOI10.1186/s12978-026-02391-0

PMCPMC13551718

What Socratic holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.