Pregnancy and contraception in a French cohort of HIV-infected women. SEROCO Study Group.
OBJECTIVE
To describe the impact of HIV diagnosis on contraception, incidence of pregnancy and live-births among HIV-infected women in France.


METHODS
Follow-up of women included in a French cohort of HIV-infected adults (SEROCO).


METHODS
In 17 hospital-based units and one private practitioners' network in the Paris area and south-east region of France, 412 HIV-infected women (volunteers) were enrolled from 1988 to 1993, shortly after HIV diagnosis (median, 3 months), and followed for a median of 3 years. The main outcome measures were incidence and outcome of pregnancy, proportions of women sexually active and methods of contraception.


RESULTS
The incidence of pregnancy decreased significantly from 20.4 per 100 person-years in the year preceding HIV diagnosis to 7.9 per 100 person-years after HIV diagnosis (P < 0.001), whereas the proportion of pregnancies voluntarily interrupted doubled (63 versus 29%). The proportion of women who were sexually inactive increased from 5% before HIV diagnosis to 20% thereafter. During followup, 80% of sexually active women were using contraceptive methods.


CONCLUSIONS
The study supports an association between the discovery of HIV infection and a decrease in the proportion of women who are sexually active, a decrease in the incidence of pregnancy in general and live-births in particular, and an increase in the proportion of pregnancies voluntarily interrupted. Nevertheless, 24% of the women became pregnant and around 20% of sexually active women were not using any contraception. The high rate of voluntary abortion may indicate that many of these pregnancies were unplanned and could have been prevented.
De Vincenzi
I
I
European Centre for the Epidemiological Monitoring of AIDS, National Hospital of Saint-Maurice, Saint-Maurice, France.
Jadand
C
C
Couturier
E
E
Brunet
J B
JB
Gallais
H
H
Gastaut
J A
JA
Goujard
C
C
Deveau
C
C
Meyer
L
L
D000028:Abortion, Induced / Q000706:statistics & numerical data; D000328:Adult; D015331:Cohort Studies; D003267:Contraception / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome