Background. Preventing unintended pregnancies among women living with HIV is an important component of prevention of mother-to-child HIV transmission (PMTCT), yet few data exist on contraceptive use among women entering HIV care. Methods. This was a retrospective study of electronic medical records from the initial HIV clinic visits of 826 sexually active, nonpregnant, 18–49-year old women in southwestern Uganda in 2009. We examined whether contraceptive use was associated with HIV status disclosure to one’s spouse. Results. The proportion reporting use of contraception was 27.8%. The most common method used was injectable hormones (51.7%), followed by condoms (29.6%), and oral contraceptives (8.7%). In multivariable analysis, the odds of contraceptive use were significantly higher among women reporting secondary education, higher income, three or more children, and younger age. There were no significant independent associations between contraceptive use and HIV status disclosure to spouse. Discussion. Contraceptive use among HIV-positive females enrolling into HIV care in southwestern Uganda was low. Our results suggest that increased emphasis should be given to increase the contraception uptake for all women especially those with lower education and income. HIV clinics may be prime sites for contraception education and service delivery integration. 1. Introduction Sub-Saharan Africa has the highest prevalence and incidence of HIV-1 infection in the world [1]. Women of reproductive age account for 60 percent of all adult infections and 75 percent of infections among people 15–24 years old [2]. Sub-Saharan Africa also has high fertility rates with an estimated 14 million unintended pregnancies annually [3]. In 2008, the number of children newly infected with HIV was approximately 430,000, of which 90 percent were infected through mother-to-child transmission (MTCT) [4]. The World Health Organization (WHO) lists preventing unintended pregnancies among people living with HIV as a second pillar of preventing mother-to-child transmission (PMTCT) [4]. Not only is preventing unintended pregnancies in HIV-infected women an effective strategy for reducing perinatal transmission [5–8], but it is also cost saving [8, 9] and would contribute to the reduction of maternal mortality, which may be higher among HIV-infected women [10–12]. However, most PMTCT efforts to date prioritize the provision of antiretroviral (ARV) prophylaxis to HIV infected pregnant women, their infants, and safer breastfeeding strategies [4, 13, 14]. In Uganda, HIV-1 seroprevalence among
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