Reproductive health of adolescent girls perinatally infected with HIV.
OBJECTIVE
We sought to describe the reproductive health of adolescent girls perinatally infected with HIV.


METHODS
We estimated the incidence of first pregnancy, genital infections, and abnormal cervical cytology for 638 girls aged 13 years and older in the Pediatric AIDS Clinical Trials Group protocol 219C.


RESULTS
Thirty-eight girls became pregnant, for a first pregnancy rate of 18.8/1000 person-years; 7 of these girls had additional pregnancies (95% confidence interval [CI]=13.3, 25.7). Thirty-two pregnancies resulted in live births. All girls received antiretroviral therapy during pregnancy. One infant was HIV infected, 29 were uninfected, and 2 had unknown infection status, for a rate of mother-to-child transmission of HIV in infants with known infection status of 3.3% (95% CI=0.1, 18.6). Condylomata and trichomoniasis were the most frequent genital infections. Forty-eight (47.5%) of 101 girls with Papanicolaou test examinations had abnormal cervical cytology, including atypical cells of undetermined significance (n=18), low-grade squamous intraepithelial lesions (SIL; n=27), and high-grade SIL (n=3). Many abnormalities persisted despite intervention.


CONCLUSIONS
Pregnancy rates were lower and cervical abnormalities were higher than among non-HIV-infected adolescents. These findings underscore the importance of Papanicolaou tests and promotion of safer sexual practices in this population.
Brogly
Susan B
SB
Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Mass 02115-6017, USA. sbrogly@sdac.harvard.edu
Watts
D Heather
DH
Ylitalo
Nathalie
N
Franco
Eduardo L
EL
Seage
George R
GR
Oleske
James
J
Eagle
Michelle
M
Van Dyke
Russell
R
D000293:Adolescent; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006293:Health Promotion; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012307:Risk Factors; D012725:Sexual Behavior; D018709:Statistics, Nonparametric; D014412:Tumor Virus Infections / Q000453:epidemiology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology