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- Title
Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa.
- Authors
Johnson, Leigh F; Mutemaringa, Themba; Heekes, Alexa; Boulle, Andrew
- Abstract
<bold>Background: </bold>Previous studies suggest that untreated human immunodeficiency virus (HIV) infection is associated with a reduced incidence of pregnancy, but studies of the effect of antiretroviral treatment (ART) on pregnancy incidence have been inconsistent.<bold>Methods: </bold>Routine data from health services in the Western Cape province of South Africa were linked to identify pregnancies during 2007-2017 and maternal HIV records. The time from the first (index) pregnancy outcome date to the next pregnancy was modeled using Cox proportional hazards models.<bold>Results: </bold>During 2007-2017, 1 042 647 pregnancies were recorded. In all age groups, pregnancy incidence rates were highest in women who had started ART, lower in HIV-negative women, and lowest in ART-naive HIV-positive women. In multivariable analysis, after controlling for the most recent CD4+ T-cell count, pregnancy incidence rates in HIV-positive women receiving ART were higher than those in untreated HIV-positive women (adjusted hazard ratio, 1.63; 95% confidence interval, 1.59-1.67) and those in HIV-negative women.<bold>Conclusion: </bold>Among women who have recently been pregnant, receipt of ART is associated with high rates of second pregnancy. Better integration of family planning into HIV care services is needed.
- Subjects
WESTERN Cape (South Africa); SOUTH Africa; SUB-Saharan Africa; HIV infections; HIV; PROPORTIONAL hazards models; PREGNANCY; HIV infection epidemiology; COMMUNICABLE disease epidemiology; ANTI-HIV agents; FAMILY planning; COMMUNICABLE diseases; BIRTH rate; DISEASE incidence; PREGNANCY complications; QUESTIONNAIRES; MEDICAL needs assessment
- Publication
Journal of Infectious Diseases, 2020, Vol 221, Issue 12, p1953
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiz362