title: [Impaired fertility in women infected with HIV-1. Implications for sentinel serosurveillance].
abstract: BACKGROUND
  Given the relationship between HIV infection and fertility, antenatal clinic-based HIV prevalence may not provide a good estimate of the community HIV prevalence. The objective of this work was to evaluate the impact of HIV infection on fertility among women attending antenatal clinics in Bobo-Dioulasso (Burkina Faso), and to discuss possible implications on HIV sentinel surveillance.
  
  
  METHODS
  In the context of a phase II/III clinical trial of a short course of Zidovudine during pregnancy (DITRAME - ANRS 049 trial) we consecutively proposed voluntary counselling and HIV testing (VCT) to 1349 women aged at least 18 years, carrying a pregnancy of 7 months or less and living in Bobo-Dioulasso. During pre-test counselling session, a standardised questionnaire was administered to collect detailed information regarding socio-demographic characteristics and obstetrical history. Blood samples were then taken and tested for HIV after written informed consent.
  
  
  RESULTS
  Mean age (+/- standard deviation) at first sexual intercourse was similar among HIV-infected (HIV+) (16.7+/- 2; n=83) and HIV-negative (HIV-) women (16.9+/- 2; n=1336). However, HIV+ women aged 25 years and above had, on the average fewer pregnancies (3.8+/- 1.5; n=37) than HIV- women (5.0+/- 2.3; n=567), p<0.01. Similarly, these HIV+ women had, on average, less live births (2.8+/- 1.3; n=35) than HIV- ones (3.7+/- 2.1; n=555), p=0.02. Other sexual and obstetrical characteristics such as maternal age, proportion of primigravidae, stillbirths or spontaneous abortions were comparable between HIV+ and HIV- women.
  
  
  CONCLUSIONS
  Our data suggest that the level of fertility of HIV+ women aged 25 years and above is significantly lower than for HIV- women. Therefore, HIV+ women in this age group are likely to be under-represented among antenatal clinic attendees. These findings suggest adjusting antenatal clinic-based HIV sentinel surveillance data for age and fertility in order to derive a good estimate of the community HIV prevalence.
authors: Centre MURAZ, Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies (OCCGE), 01 B.P. 153 Bobo-Dioulasso 01, Burkina Faso.
authors: S
authors: S
authors: Yaro
authors: N
authors: N
authors: Meda
authors: A
authors: A
authors: Desgrées Du Loû
authors: I
authors: I
authors: Sombie
authors: M
authors: M
authors: Cartoux
authors: S
authors: S
authors: Tiendrebeogo
authors: A
authors: A
authors: Ouangre
authors: B
authors: B
authors: Dao
authors: B
authors: B
authors: Nacro
authors: A
authors: A
authors: Kpozehouen
authors: Y
authors: Y
authors: Nebie
authors: P
authors: P
authors: Fao
authors: O
authors: O
authors: Ky-Zerbo
authors: P
authors: P
authors: Van De Perre
authors: L
authors: L
authors: Mandelbrot
authors: F
authors: F
authors: Dabis
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015982:Bias; D002050:Burkina Faso / Q000453:epidemiology; D016022:Case-Control Studies; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D018023:HIV Seronegativity; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000821:virology*; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data