Sexual behavior and pregnancy outcome in HIV-infected women. Canadian Women's HIV Study Group.
Sexual behavior and pregnancy outcome data for 392 HIV-infected women were analyzed. During the 6 months before study entry, 71.2% (279 of 392 women) were sexually active. In multivariate regression, women with baseline CD4+ > or = 200/microl were more likely than women with CD4+ < 200/microl to be sexually active (adjusted odds ratio [OR] = 1.75; 95% confidence interval [CI], 1.06-2.88; p = .03). Consistent condom use was reported with 58.4% (149 of 255) of steady male partners and 65.7% (23 of 35) of casual partners. Overall, 90.3% of 279 sexually active women were using contraception. Among women aged between 15 and 44 years (n = 320), the incidence of pregnancy in the year before HIV diagnosis was 27.5 per 100 person-years (PY) (95% CI, 22.1-33.9) compared with 8.3/100 PY (95% CI, 6.8-10.2) in the time since HIV diagnosis (p < .001). The incidence of therapeutic termination of pregnancies conceived in the 20 weeks before HIV diagnosis (10.6/100 PY) was more than triple that after diagnosis (3.1/100 PY; p = .001). After publication of results of zidovudine prophylaxis of mother-to-child transmission, pregnancy rates did not increase, but the incidence of therapeutic abortion dropped from 4.3/100 PY to 1.4/100 PY (p = .009). Knowledge of sexual behavior, including pregnancy frequency and outcome, can assist in tailoring counseling for HIV-infected women concerning sexual and reproductive health.
Montreal Regional Public Health Department, and McGill AIDS Centre, McGill University, Québec, Canada. md77@musica.mcgill.ca
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D000032:Abortion, Therapeutic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D018791:CD4 Lymphocyte Count; D002170:Canada; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior; D005260:Female; D015658:HIV Infections / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology* / Q000523:psychology; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012725:Sexual Behavior; D012747:Sexual Partners; D044465:White People