title: Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil.
abstract: OBJECTIVE
  To assess incidence and predictors of first pregnancy among women with HIV/AIDS.
  
  
  METHODS
  Prospective cohort study was conducted in Rio de Janeiro, southeastern Brazil, between 1996 and 2003. This study comprised 225 women with HIV/AIDS followed up until their first pregnancy or first censored event (hysterectomy, tubal ligation, menopause, 50 years of age, loss to follow-up, death or the end of December 2003). Pregnancy and abortion rates were estimated, and Cox proportional hazards models were used to identify baseline characteristics associated with pregnancy risk.
  
  
  RESULTS
  The women were followed up for 565 person/years with a median follow-up of 3 years per women. The mean age was 32 years (SD: 7), and 54.7% were white. There were 60 pregnancies in 39 women, and 18 were terminated (induced abortions), accounting for a rate of 6.9% and 2.1% women/year, respectively. Repeated pregnancies occurred in 33.3% of the women (13/39). Higher pregnancy risk was seen among younger women (HR=3.42; 95%CI: 1.69;6.95) and those living with their partners (HR=1.89; 95%CI: 1.00;3.57). Lower pregnancy risk was associated with higher education level (HR=0.43; 95%CI: 0.19;0.99) and use of antiretroviral therapy (HR=061; 95%CI: 0.31;1.17).
  
  
  CONCLUSIONS
  Lower pregnancy rates were found in our cohort than in the general population. Sociodemographic characteristics should be taken into consideration in the management of reproductive health in HIV-positive childbearing age women. Reproductive and family planning counseling must be incorporated into HIV/AIDS programs for women to help preventing HIV transmission to their partners and offspring.
authors.affiliation: Laboratório de Pesquisa em DST/Aids, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4, Rio de Janeiro, RJ, Brazil. ruthkf@fi ocruz.br
authors.forename: Ruth Khalili
authors.initials: RK
authors.lastname: Friedman
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
authors.forename: Iuri Costa
authors.initials: IC
authors.lastname: Leite
authors.forename: Valdiléa G
authors.initials: VG
authors.lastname: Veloso
authors.forename: Ronaldo I
authors.initials: RI
authors.lastname: Moreira
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Cardoso
authors.forename: Angela C Vasconcelos de
authors.initials: AC
authors.lastname: Andrade
authors.forename: Michelle Cristina
authors.initials: MC
authors.lastname: Sampaio
authors.forename: Judith
authors.initials: J
authors.lastname: Currier
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D043762:Reproductive Behavior / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D044966:Anti-Retroviral Agents