Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil

Abstract

OBJECTIVE:To assess incidence and predictors of fi rst pregnancy among women with HIV/AIDS. METHODS:Prospective cohort study was conducted in Rio de Janeiro, southeastern Brazil, between 1996 and2003. This study comprised 225 women with HIV/AIDS followed up until their fi rst pregnancy or fi rst censored event (hysterectomy, tubal ligation, menopause, 50 years of age, loss to follow-up, death or the end of December 2003). Pregnancy and abortion rates were estimated, and Cox proportional hazards models were used to identify baseline characteristics associated with pregnancy risk. RESULTS:The women were followed up for 565 person/years with a median follow-up of 3 years per women. The mean age was 32 years (SD: 7), and 54.7% were white. There were 60 pregnancies in 39 women, and 18 were terminated (induced abortions), accounting for a rate of 6.9% and 2.1% women/ year, respectively. Repeated pregnancies occurred in 33.3% of the women (13/39). Higher pregnancy risk was seen among younger women (HR=3.42; 95%CI: 1.69;6.95) and those living with their partners (HR=1.89; 95%CI: 1.00;3.57). Lower pregnancy risk was associated with higher education level (HR=0.43; 95%CI: 0.19;0.99) and use of antiretroviral therapy (HR=061; 95%CI: 0.31;1.17). CONCLUSIONS:Lower pregnancy rates were found in our cohort than in the general population. Sociodemographic characteristics should be taken into consideration in the management of reproductive health in HIV-positive childbearing age women. Reproductive and family planning counseling must be incorporated into HIV/AIDS programs for women to help preventing HIV transmission to their partners and offspring.

Rate, correlates and outcomes of repeat pregnancy in HIV‐infected women

“…Overall, the information collected in this study on repeat pregnancy among women with HIV infection confirms some of the findings obtained by others and offers new insights: as already shown by others, repeat pregnancy in women with HIV infection was associated with younger age , foreign country of origin , and parity (no prior pregnancies) . We also showed that women with subsequent pregnancies were more likely to have been diagnosed with HIV infection in the current pregnancy, but also more likely to have a first pregnancy ending in no live birth, a finding common to the study by Kreitchmann et al .…”

Lifetime Induced Abortion: A Comparison between Women Living and Not Living with HIV

“…There are few studies that examine the association between HIV and induced abortion [42], especially regarding the comparison between WLHA and WNLHA [13]–[15], [38]. Moreover, the scenario in which these studies were performed is different.…”

“…In comparison, other studies have focused on specific pregnancies, analyzing abortion and HIV status in each pregnancy (e.g., last pregnancy before and first pregnancy after HIV diagnosis [11], [12], or pregnancies that occurred during the study period [13], [14], [35], [38]). …”

Absence of Effect of Menopause Status at Initiation of First-Line Antiretroviral Therapy on Immunologic or Virologic Responses: A Cohort Study from Rio de Janeiro, Brazil

“…To study the natural history of HIV infection in women, a prospective open cohort was established at IPEC in 1996. Study visits occur every 6 months; sociodemographic, behavior, reproductive, gynecologic and laboratory data are collected using structured questionnaires [20], [21].…”