Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain.
The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.A cross-sectional study was performed among women within reproductive ages (18-49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women's serostatus at the moment of pregnancy and association of women's characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models.Overall, 161 women were interviewed; of them, 86% had been pregnant at least once and 39% after HIV diagnosis. There were 347 pregnancies, 29% of them occurred after HIV diagnosis and in these, 20% were miscarriages and 29% were voluntary termination of pregnancy. There were 3 cases of mother-to-child transmission among the 56 children born from HIV-positive mothers; in these cases, women were diagnosed during delivery. Having a pregnancy after HIV diagnosis was more likely when the younger women were at the time of diagnosis: odds ratio (OR) = 1.29 (95% confidence interval 0.40-4.17) for 25 to 29 years old, OR = 0.59 (0.15-2.29) for 30 to 34 years old, OR = 0.14 (0.03-0.74) for ≥35 years old, compared with those <25 years at diagnosis, who were diagnosed for ≥5 years (OR = 5.27 [1.71-16.18]), who received antiretroviral treatment at some point (OR = 9.38 [1.09-80.45]), and who received information on reproductive health (OR = 4.32 [1.52-12.26]).An important number of pregnancies occurred after HIV diagnosis, reflecting a desire for motherhood in these women. Reproductive and sexual health should be tackled in medical follow-ups.
Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III CIBER de Epidemiología y Salud Pública (CIBERESP) Hospital Universitario La Fe, Valencia Hospital Universitario Ramón y Cajal, Madrid Hospital Universitario San Pedro-CIBIR, Logroño Hospital Universitario de Alicante, Alicante Hospital Universitario de Canarias, Tenerife Hospital Universitario Donostia, Donostia Hospital Universitario Reina Sofia, Murcia Universidad de Alcalá, Alcalá de Henares, Madrid, Spain City University of New York School of Public Health at Hunter College, New York, USA.
Victoria
V
Hernando
Belen
B
Alejos
Marta
M
Montero
MªJesús
M
Pérez-Elias
José Ramón
JR
Blanco
Livia
L
Giner
Juan Luis
JL
Gómez-Sirvent
Jose Antonio
JA
Iribarren
Enrique
E
Bernal
Francisco
F
Bolumar
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D011256:Pregnancy Outcome; D015995:Prevalence; D017584:Reproductive History; D013030:Spain / Q000453:epidemiology; D055815:Young Adult