Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda
Identifieur interne : 001261 ( Ncbi/Checkpoint ); précédent : 001260; suivant : 001262Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda
Auteurs : Fredrick. E. Makumbi ; Gertrude Nakigozi [Ouganda] ; Steven. J. Reynolds [États-Unis] ; Anthony Ndyanabo [Ouganda] ; Tom Lutalo [Ouganda] ; David Serwada [Ouganda] ; Fred Nalugoda [Ouganda] ; Maria Wawer [États-Unis] ; Ron Gray [États-Unis]Source :
- AIDS Research and Treatment [ 2090-1240 ] ; 2011.
Abstract
Url:
DOI: 10.1155/2011/519492
PubMed: 21490780
PubMed Central: 3066572
Affiliations:
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<author><name sortKey="Makumbi, Fredrick E" sort="Makumbi, Fredrick E" uniqKey="Makumbi F" first="Fredrick. E." last="Makumbi">Fredrick. E. Makumbi</name>
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<affiliation><nlm:aff>NONE</nlm:aff>
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<author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name>
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<country xml:lang="fr">Ouganda</country>
<wicri:regionArea>Rakai Health Sciences Program, 279 Kalisizo</wicri:regionArea>
<wicri:noRegion>279 Kalisizo</wicri:noRegion>
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<author><name sortKey="Reynolds, Steven J" sort="Reynolds, Steven J" uniqKey="Reynolds S" first="Steven. J." last="Reynolds">Steven. J. Reynolds</name>
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<country xml:lang="fr">États-Unis</country>
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<placeName><region type="state">Maryland</region>
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<author><name sortKey="Ndyanabo, Anthony" sort="Ndyanabo, Anthony" uniqKey="Ndyanabo A" first="Anthony" last="Ndyanabo">Anthony Ndyanabo</name>
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<country xml:lang="fr">Ouganda</country>
<wicri:regionArea>Rakai Health Sciences Program, 279 Kalisizo</wicri:regionArea>
<wicri:noRegion>279 Kalisizo</wicri:noRegion>
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<author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name>
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<country xml:lang="fr">Ouganda</country>
<wicri:regionArea>Rakai Health Sciences Program, 279 Kalisizo</wicri:regionArea>
<wicri:noRegion>279 Kalisizo</wicri:noRegion>
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<author><name sortKey="Serwada, David" sort="Serwada, David" uniqKey="Serwada D" first="David" last="Serwada">David Serwada</name>
<affiliation wicri:level="1"><nlm:aff id="I1">School of Public Health, Makerere University, 7072 Kampala, Uganda</nlm:aff>
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<wicri:regionArea>School of Public Health, Makerere University, 7072 Kampala</wicri:regionArea>
<wicri:noRegion>7072 Kampala</wicri:noRegion>
</affiliation>
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<author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name>
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<wicri:noRegion>279 Kalisizo</wicri:noRegion>
</affiliation>
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<author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
<affiliation wicri:level="2"><nlm:aff id="I4">School of Public Health, Johns Hopkins Bloomberg, MD 21205, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Public Health, Johns Hopkins Bloomberg, MD 21205</wicri:regionArea>
<placeName><region type="state">Maryland</region>
</placeName>
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<author><name sortKey="Gray, Ron" sort="Gray, Ron" uniqKey="Gray R" first="Ron" last="Gray">Ron Gray</name>
<affiliation wicri:level="2"><nlm:aff id="I4">School of Public Health, Johns Hopkins Bloomberg, MD 21205, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Public Health, Johns Hopkins Bloomberg, MD 21205</wicri:regionArea>
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<series><title level="j">AIDS Research and Treatment</title>
<idno type="ISSN">2090-1240</idno>
<idno type="eISSN">2090-1259</idno>
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<front><div type="abstract" xml:lang="en"><p><italic>Background</italic>
. Use of antiretroviral therapy (ART) may be associated with higher pregnancy rates.
<italic>Methods</italic>
. The prevalence and incidence of pregnancy was assessed in 712 HIV+ pre-ART women of reproductive age (WRA) (15–45) and 244 HIV+ WRA initiating ART. Prevalence rate ratios (PRR), incidence rate ratios (IRR), and 95% confidence interval (CI) were assessed.
<italic>Results</italic>
. The incidence of pregnancy was 13.1/100 py among women in pre-ART care compared to 24.6/100 py among women on ART (IRR = 0.54; 95% CI 0.37, 0.81, <italic>p</italic>
< 0.0017). The prevalence of pregnancy at ART initiation was 12.0% with CD4 counts 100–250 compared with 3.2% with CD4 <100 (PRR = 3.24, CI 1.51–6.93), and the incidence of pregnancy while on ART was highest in women with a good immunologic response. Desire for more children was a very important factor in fertility.
<italic>Conclusion</italic>
. ART was associated with increased pregnancy rates in HIV+ women, particularly those with higher CD4 counts and good immunologic response to therapy, suggesting a need to strengthen reproductive health services for both women and their partners that could address their fertility decisions/intentions particularly after ART initiation.
</p>
</div>
</front>
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<tree><noCountry><name sortKey="Makumbi, Fredrick E" sort="Makumbi, Fredrick E" uniqKey="Makumbi F" first="Fredrick. E." last="Makumbi">Fredrick. E. Makumbi</name>
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<name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name>
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