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Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain.

ABSTRACT: The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.A cross-sectional study was performed among women within reproductive ages (18-49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women's serostatus at the moment of pregnancy and association of women's characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models.Overall, 161 women were interviewed; of them, 86% had been pregnant at least once and 39% after HIV diagnosis. There were 347 pregnancies, 29% of them occurred after HIV diagnosis and in these, 20% were miscarriages and 29% were voluntary termination of pregnancy. There were 3 cases of mother-to-child transmission among the 56 children born from HIV-positive mothers; in these cases, women were diagnosed during delivery. Having a pregnancy after HIV diagnosis was more likely when the younger women were at the time of diagnosis: odds ratio (OR)?=?1.29 (95% confidence interval 0.40-4.17) for 25 to 29 years old, OR?=?0.59 (0.15-2.29) for 30 to 34 years old, OR?=?0.14 (0.03-0.74) for ?35 years old, compared with those <25 years at diagnosis, who were diagnosed for ?5 years (OR?=?5.27 [1.71-16.18]), who received antiretroviral treatment at some point (OR?=?9.38 [1.09-80.45]), and who received information on reproductive health (OR?=?4.32 [1.52-12.26]).An important number of pregnancies occurred after HIV diagnosis, reflecting a desire for motherhood in these women. Reproductive and sexual health should be tackled in medical follow-ups.

SUBMITTER: Hernando V

PROVIDER: S-EPMC5293456 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain.

Hernando Victoria V Alejos Belen B Montero Marta M Pérez-Elias MªJesús M Blanco José Ramón JR Giner Livia L Gómez-Sirvent Juan Luis JL Iribarren Jose Antonio JA Bernal Enrique E Bernal Enrique E Bolumar Francisco F

Medicine 20170201 5

The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.A cross-sectional study was performed among women within reproductive ages (18-49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made a ...[more]

PMID: 28151893

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Project description:BackgroundImprovements in life expectancy and quality of life for HIV-positive women coupled with reduced vertical transmission will likely lead numerous HIV-positive women to consider becoming pregnant. In order to clarify the demand, and aid with appropriate health services planning for this population, our study aims to assess the fertility desires and intentions of HIV-positive women of reproductive age living in Ontario, Canada.Methodology/principal findingsA cross-sectional study with recruitment stratified to match the geographic distribution of HIV-positive women of reproductive age (18-52) living in Ontario was carried out. Women were recruited from 38 sites between October 2007 and April 2009 and invited to complete a 189-item self-administered survey entitled "The HIV Pregnancy Planning Questionnaire" designed to assess fertility desires, intentions and actions. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios of significant predictors of fertility intentions. The median age of the 490 participating HIV-positive women was 38 (IQR, 32-43) and 61%, 52%, 47% and 74% were born outside of Canada, living in Toronto, of African ethnicity and currently on antiretroviral therapy, respectively. Of total respondents, 69% (95% CI, 64%-73%) desired to give birth and 57% (95% CI, 53%-62%) intended to give birth in the future. In the multivariable model, the significant predictors of fertility intentions were: younger age (age<40) (p<0.0001), African ethnicity (p<0.0001), living in Toronto (p = 0.002), and a lower number of lifetime births (p = 0.02).Conclusions/significanceThe proportions of HIV-positive women of reproductive age living in Ontario desiring and intending pregnancy were higher than reported in earlier North American studies. Proportions were more similar to those reported from African populations. Healthcare providers and policy makers need to consider increasing services and support for pregnancy planning for HIV-positive women. This may be particularly significant in jurisdictions with high levels of African immigration.

Project description:BACKGROUND: In settings where sexually transmitted infection (STI) and HIV prevalence is high, the postpartum period is a time of increased biological susceptibility to pregnancy related sepsis. Enabling women living with HIV to avoid unintended pregnancies during the postpartum period can reduce vertical transmission and maternal mortality associated with HIV infection. We describe family planning (FP) practices and fertility desires of HIV-positive and HIV-negative postpartum women in Swaziland. METHODS: Data are drawn from a baseline survey of a four-year multi country prospective cohort study under the Integra Initiative, which is measuring the benefits and costs of providing integrated HIV and sexual and reproductive health (SRH) services in Kenya and Swaziland. We compare data from 386 HIV-positive women and 483 HIV-negative women recruited in Swaziland between February and August 2010. Data was collected on hand-held personal digital assistants (PDAs) covering fertility desires, mistimed or unwanted pregnancies and contraceptive use prior to their most recent pregnancy. Data were analysed using Stata 10.0. Descriptive statistics were conducted using the chi square test for categorical variables. Measures of effect were assessed using multivariate fixed effects logistic regression model accounting for clustering at facility level and the results are presented as adjusted odds ratios. RESULTS: Majority (69.2%) of postpartum women reported that their most recent pregnancy was unintended with no differences between HIV-positive and HIV-negative women: OR: 0.96 (95% CI) (0.70, 1.32). Although, there were significant differences between HIV-positive and HIV-negative women who reported that their previous pregnancy was unwanted, (20.7% vs. 13.5%, p?=?0.004), when adjusted this was not significant OR: 1.43 (0.92, 1.91). 47.2% of HIV-positive women said it was mistimed compared to 52.5%, OR: 0.79 (0.59, 1.06). 37.9% of all women said they do not want another child. Younger women were more likely to have unwanted pregnancies: OR: 1.12 (1.07, 1.12), while they were less likely to have mistimed births; OR: 0.82 (0.70, 0.97). Those with tertiary education were less likely to have unwanted or mistimed pregnancies OR: 0.30 (0.11, 0.86). Half of HIV-positive women and more than a third of HIV-negative women reported that they had been using a FP method when they became pregnant with no differences between the groups: OR: 1.61 (0.82,3.41). Only short-acting methods were available to these women before the most recent pregnancy; and available during the postpartum visit. One fifth of all women received an FP method during the current visit. Among the four fifths who did not receive a method 17.3% reported they were already using a method or were breastfeeding. HIV-positive women were more likely to have already started a method than HIV-negative women (20% vs. 15%, p?=?0.089). CONCLUSION: There are few differences overall between the experiences of both HIV-positive and negative women in terms of FP experiences, unintended pregnancy and services received during the early postpartum period in Swaziland. Women attending postpartum facilities are receiving satisfactory care. Access to a wider range of effective methods is urgently needed if high levels of unintended pregnancy are to be reduced among HIV-positive and HIV-negative women living in Swaziland.

Project description:BackgroundContraception helps prevent unplanned pregnancies and mother to child Human Immune Virus (HIV) transmission among human immune virus positive women. Ethiopia has made remarkable progress in increasing contraceptive use rate but there is still a disparity of contraceptive use within the country. Although there were some studies about contraceptive use in Ethiopia, evidences about contraceptive use among sexually active HIV positive women was limited. Understanding the extent of and barriers in Ethiopia is important for learning how to best improve level of contraceptive use. Therefore, this study aimed to assess contraceptives use and associated factors among HIV positive sexually active women at anti-retroviral therapy clinic at Felege Hiwot Referral Hospital ART clinic in Bahir Dar, Ethiopia.MethodA facility-based cross-sectional study was conducted from June 01-30, 2018 among (n = 308) randomly selected HIV positive women at Felege Hiwot Referral Hospital. Data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS version 20. Survey logistic regression analysis was employed to identify determinants of contraceptive use. Statistical significance was declared at p-value <0.05.ResultsOut of three hundred eight participants, 118 (38.3%) reported contraceptive use at the time of the study. Injectable is the most preferred (43.5%) contraceptive method. Participants with age 15-34 years (AOR = 3.09, 95%CI: 1.59-5.99), disclosed their status to sex partner, (AOR = 2.7, 95%CI: 1.14-6.66), had history of contraception use; (AOR = 3.36, 95%CI: 1.68-6.74), were sexually active (AOR = 5.45, 95%CI: 2.72-10.91) had higher odds of contraceptive use. However, participants who had drinking habit (AOR = 4.35, 95%CI: 1.82-10.38) had lower odds of contraceptive use.ConclusionA significant proportion of HIV positive women had low level of contraceptive use that was lower than the national recommended level. Participants with younger age (15-34years), who disclosed HIV status to sex partner, had history of contraceptive use, and who were sexually active six months prior to the study were more likely to use contraception. However, participants who had drinking habit were less likely to use contraception. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to increase contraceptive use in the HIV positive women.

Project description:ObjectivesTo assess the usage of cervical cancer screening services and associated factors among HIV-positive women on antiretroviral treatment in Southern Ethiopia in 2020.DesignA multicentre cross-sectional study.SettingThe study was conducted in Wolaita Sodo University Teaching Referral Hospital and Sodo Health Centre, Southern Ethiopia, from 1 July 2020 to 30 September 2020.ParticipantsFour hundred and seventeen HIV-positive women on antiretroviral treatment attending public health facilities were approached during the study period. A multivariable binary logistic regression model was carried out to identify independent factors associated with the usage of cervical cancer screening services, and a p value<0.05 was used to declare statistical significance.ResultsThe uptake of cervical cancer screening services among HIV-positive women was 27.8% with a 95% CI of 24.2% to 33.1%. Married women and women reporting a high level of perceived barriers were 75% and 66% less likely to receive cervical cancer screening services, adjusted OR (AOR)=0.25; 95% CI: 0.07 to 0.93, and AOR=0.34; 95% CI: 0.12 to 0.98, respectively. Whereas, being a government employee, AOR=3.85; 95% CI: 1.31 to 11.3, sexual debut before the age of 20, AOR=2.39; 95% CI: 1.09 to 5.26, using modern contraceptives, AOR=2.43; 95% CI: 1.05 to 5.65, having a high perceived self-efficacy, AOR=4.42; 95% CI: 1.79 to 10.89 and having a high perceived benefit of cervical cancer screening services, AOR=12.23; 95% CI: 2.22 to 67.35 were significantly associated with the usage of cervical cancer screening services.ConclusionsThe usage of cervical cancer screening services among HIV-positive women remains low in this setting. Married HIV-positive women and those with a high perceived barrier were associated with low uptake of cervical cancer screening services. Being a government employee, having an early sexual experience, using modern contraceptives, having a high perceived self-efficacy and having a high perceived benefit were identified as factors associated with increased uptake of cervical cancer screening services.

Project description:ObjectivesPrevention of unplanned pregnancy is a crucial aspect of preventing mother-to-child HIV transmission. There are few data investigating how HIV status and use of antiretroviral therapy (ART) may influence pregnancy planning in high HIV burden settings. Our objective was to examine the prevalence and determinants of unplanned pregnancy among HIV-positive and HIV-negative women in Cape Town, South Africa.DesignCross-sectional analysis.SettingsSingle primary-level antenatal care clinic in Cape Town, South Africa.ParticipantsHIV-positive and HIV-negative pregnant women, booking for antenatal care from March 2013 to August 2015, were included.Main outcome measuresUnplanned pregnancy was measured at the first antenatal care visit using the London Measure of Unplanned Pregnancy (LMUP). Analyses examined LMUP scores across four groups of participants defined by their HIV status, awareness of their HIV status prior to the current pregnancy and/or whether they were using antiretroviral therapy (ART) prior to the current pregnancy.ResultsAmong 2105 pregnant women (1512 HIV positive; 593 HIV negative), median age was 28 years, 43% were married/cohabiting and 20% were nulliparous. Levels of unplanned pregnancy were significantly higher in HIV-positive versus HIV-negative women (50% vs 33%, p<0.001); and highest in women who were known HIV positive but not on ART (53%). After adjusting for age, parity and marital status, unplanned pregnancy was most common among women newly diagnosed and women who were known HIV positive but not on ART (compared with HIV-negative women, adjusted OR (aOR): 1.43; 95% CI 1.05 to 1.94 and aOR: 1.57; 95% CI 1.13 to 2.15, respectively). Increased parity and younger age (<24 years) were also associated with unplanned pregnancy (aOR: 1.42; 95% CI 1.25 to 1.60 and aOR: 1.83; 95% CI 1.23 to 2.74, respectively).ConclusionsWe observed high levels of unplanned pregnancy among HIV-positive women, particularly among those not on ART, suggesting ongoing missed opportunities for improved family planning and counselling services for HIV-positive women.

Dataset Information

Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain.

Publications

Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain.

Similar Datasets

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