Sexual Risk and Intravaginal Practice Behavior Changes During Pregnancy.
Data suggest that pregnant women in some settings have high prevalence of HIV and other sexually transmitted infections (STI). We examined changes in sexual risk behaviors and intravaginal practices during pregnancy that may contribute to HIV and STI incidence using data from the Methods for Improved Reproductive Health in Africa study conducted in South Africa and Zimbabwe 2003-2006. We used a crossover design and modified Poisson regression to compare behaviors among HIV negative women 18-45 years during pregnant and non-pregnant periods. Among the 4802 women <45 years at enrollment, 483 (10.1 %) had a pregnancy and were included in the analysis. Compared to non-pregnant periods, pregnancy was associated with fewer than 3 sex acts per week (adjusted risk ratio [ARR] 0.89; 95 % CI 0.79-0.99) but more sex acts without condoms (ARR 1.32; 95 % CI 1.15-1.51). Pregnancy was also associated with decreased reporting of other sexual risk behaviors including any anal sex, multiple sexual partners, and/or sex in exchange for drugs or money. Women also reported less intravaginal wiping during pregnancy (ARR 0.84; 95 % CI 0.76-0.93). We found pregnancy decreased sexual activity and some high-risk sexual behaviors but increased the risk of sex without a condom.
International Center for AIDS Care and Treatment Programs (ICAP), Mailman School of Public Health, Columbia University, 722 W 168th Street, Room 1319, New York, NY, 10032, USA. ct116@columbia.edu.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. ct116@columbia.edu.
Chloe A
CA
Teasdale
International Center for AIDS Care and Treatment Programs (ICAP), Mailman School of Public Health, Columbia University, 722 W 168th Street, Room 1319, New York, NY, 10032, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Elaine J
EJ
Abrams
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.|Public Health Solutions, New York, NY, USA.
Mary Ann
MA
Chiasson
International Center for AIDS Care and Treatment Programs (ICAP), Mailman School of Public Health, Columbia University, 722 W 168th Street, Room 1319, New York, NY, 10032, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Jessica
J
Justman
Ibis Reproductive Health, Cambridge, MA, USA.
Kelly
K
Blanchard
Department of Epidemiology, Hunter College, City University of New York School of Public Health, New York, NY, USA.
Heidi E
HE
Jones
D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D015030:Zimbabwe / Q000453:epidemiology
Intravaginal practices; Pregnancy; Sexual risk behaviors