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Objective:

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples’ voluntary HIV counselling and testing services in Lusaka, Zambia.

Design:

Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching.

Methods:

We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen–Gill models.

Results:

Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was …