title: Preconception counseling and care in the setting of HIV: clinical characteristics and comorbidities.
abstract: OBJECTIVE
  To describe the demographic and clinical characteristics of HIV-infected individuals and HIV-affected couples who were referred for preconception counseling (PCC) at a large urban US-based HIV clinic.
  
  
  METHODS
  Electronic medical records were reviewed for HIV-infected individuals and HIV-affected couples. Medical, reproductive, surgical, psychosocial, and family history data were abstracted. Univariate analyses were done.
  
  
  RESULTS
  There were 8 single HIV-infected women and 100 HIV-affected couples who underwent PCC. HIV-infected women were older (mean age 35 years versus 32 years, P = 0.06), were more likely to smoke (23% versus 0%, P < 0.01), and had more medical comorbidities (57% versus 33%, P = 0.04) than HIV-uninfected women. The majority of couples were serodiscordant (77%), and of these couples, 32% had a detectable plasma viral load and 33% report inconsistent condom use.
  
  
  CONCLUSIONS
  HIV-infected women have a number of medical and psychosocial issues, including those related to HIV that may increase the risk of adverse pregnancy outcomes and HIV perinatal and sexual transmission. PCC is an important intervention to optimize maternal management to improve perinatal outcomes and minimize transmission risks.
authors.affiliation: Department of Obstetrics & Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: Rupsa C
authors.initials: RC
authors.lastname: Boelig
authors.affiliation: Division of Gynecologic Specialties, Department of Obstetrics & Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Jenell S
authors.initials: JS
authors.lastname: Coleman
authors.affiliation: Division of Gynecologic Specialties, Department of Obstetrics & Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Keller
authors.affiliation: Division of Gynecologic Specialties, Department of Obstetrics & Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Food and Drug Administration, U.S. Department of Health and Human Services, Silver Spring, MD 20993, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sewell
authors.affiliation: Division of Gynecologic Specialties, Department of Obstetrics & Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Anderson
mesh_terms: D000328:Adult; D015897:Comorbidity; D003376:Counseling; D005260:Female; D015658:HIV Infections; D006801:Humans; D008297:Male; D016742:Preconception Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D012189:Retrospective Studies
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