Resumption of sexual activity and regular menses after childbirth among women infected with HIV in Malawi.
OBJECTIVE
To determine the factors associated with resumption of sexual activity and regular menses after childbirth among women infected with HIV-1.


METHODS
Information on sociodemographic, behavioral, and clinical factors was obtained from 2 HIV perinatal studies (NVAZ and PEPI trials) conducted in Malawi, 2000-2009. Factors associated with resumption of sexual activity and menses were analyzed using Cox proportional hazard models.


RESULTS
A total of 1838 women from the NVAZ study and 2982 women from the PEPI study were included in the analysis. Resumption of sexual activity was primarily associated with sociodemographic factors (e.g. in the PEPI study, marital status [adjusted hazard ratio (aHR) 0.56, P<0.001], use of contraceptive method [aHR 8.0, P<0.001], and breastfeeding [aHR 0.52, P<0.001]), whereas resumption of regular menses in the PEPI study was primarily associated with biological factors (e.g. plasma viral load [aHR 0.89, P<0.006], and breastfeeding [aHR 0.23, P<0.001).


CONCLUSIONS
HIV-infected women need adequate counseling to take into account their HIV infection status before resuming sexual activity after childbirth.
Makanani
Bonus
B
Department of Obstetrics and Gynecology and Medicine, University of Malawi, Blantyre, Malawi.
Kumwenda
Johnstone
J
Kumwenda
Newton
N
Chen
Shu
S
Tsui
Amy
A
Taha
Taha E
TE
D000328:Adult; D001942:Breast Feeding; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology / Q000821:virology; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008598:Menstruation; D010353:Patient Education as Topic; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019562:Viral Load; D055815:Young Adult