Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda. (20th December 2010)

• Record Type: Journal Article
• Authors: Makumbi, Fredrick. E.; Nakigozi, Gertrude; Reynolds, Steven. J.; Ndyanabo, Anthony; Lutalo, Tom; Serwada, David; Nalugoda, Fred; Wawer, Maria; Gray, Ron
• Other Names: Duerr Ann Academic Editor.
• Is Part Of: AIDS research and treatment. Volume 2011(2011)
• Publication Date: 2010-12-20
• Subjects: AIDS (Disease) -- Periodicals; AIDS (Disease) -- Research -- Periodicals; AIDS (Disease) -- Treatment -- Periodicals; AIDS (Disease) -- Patients -- Care -- Periodicals; AIDS (Disease) -- Patients -- Services for -- Periodicals; 616.979205
• DOI: 10.1155/2011/519492
• Languages: English
• ISSNs: 2090-1240

Abstract

Abstract : Background . Use of antiretroviral therapy (ART) may be associated with higher pregnancy rates. Methods . The prevalence and incidence of pregnancy was assessed in 712 HIV+ pre-ART women of reproductive age (WRA) (15–45) and 244 HIV+ WRA initiating ART. Prevalence rate ratios (PRR), incidence rate ratios (IRR), and 95% confidence interval (CI) were assessed. Results . The incidence of pregnancy was 13.1/100 py among women in pre-ART care compared to 24.6/100 py among women on ART (IRR = 0.54; 95% CI 0.37, 0.81, p < 0.0017 ). The prevalence of pregnancy at ART initiation was 12.0% with CD4 counts 100–250 compared with 3.2% with CD4 <100 (PRR = 3.24, CI 1.51–6.93), and the incidence of pregnancy while on ART was highest in women with a good immunologic response. Desire for more children was a very important factor in fertility. Conclusion . ART was associated with increased pregnancy rates in HIV+ women, particularly those with higher CD4 counts and good immunologic response to therapy, suggesting a need to strengthen reproductive health services for both women and their partners that could address their fertility decisions/intentions particularly after ART initiation.