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Author Notes:

Lisa Rahangdale, MD, MPH, 3031 Old Clinic Bldg, CB # 7570, Chapel Hill, NC 27516, 919-843-7851 (phone), 919-966-6001 (fax), Lisa_Rahangdale@med.unc.edu

The authors would like to thank the patients and clinic staff at our study sites for participation.

Additionally, we would like to acknowledge the University of North Carolina Center for AIDS Research (CFAR) Social and Behavioral Science Research Core for their assistance in survey design, database development, data entry and statistical analysis.

Authors reported no conflicts of interest.

Research Funding:

This research was funded in its entirety by a 2010 developmental grant from the University of North Carolina at Chapel Hill Center for AIDS Research (CFAR), an NIH funded program P30 AI50410.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • serodiscordant
  • pregnancy
  • pregnancy intention
  • HIV
  • serodifferent
  • PREEXPOSURE PROPHYLAXIS
  • INFECTED WOMEN
  • CLINICAL CARE
  • PREVENTION
  • TRANSMISSION
  • INTERVENTIONS
  • DISPARITIES
  • HEALTH
  • RATES

Pregnancy Intentions Among Women Living With HIV in the United States

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Journal Title:

Journal of Acquired Immune Deficiency Syndromes

Volume:

Volume 65, Number 3

Publisher:

, Pages 306-311

Type of Work:

Article | Post-print: After Peer Review

Abstract:

BACKGROUND:: The number of HIV-infected women giving birth in the United States is increasing. Research on pregnancy planning in HIV-infected women is limited. METHODS:: Between January 1 and December 30, 2012, pregnant women with a known HIV diagnosis before conception at 12 US urban medical centers completed a survey including the London Measure of Unplanned Pregnancy (LMUP) scale. We assessed predictors of LMUP category (unplanned/ambivalent versus planned pregnancy) using bivariate and multivariable analyses. RESULTS:: Overall, 172 women met inclusion criteria and completed a survey. Based on self-report using the LMUP scale, 23% women had an unplanned pregnancy, 58% were ambivalent, and 19% reported a planned pregnancy. Women were at lower risk for an unplanned or ambivalent pregnancy if they had previously given birth since their HIV diagnosis [adjusted relative risk (aRR) = 0.67, 95% confidence interval (CI): 0.47 to 0.94, P = 0.02], had seen a medical provider in the year before the index pregnancy (aRR = 0.60, 95% CI: 0.46 to 0.77, P < 0.01), or had a patient-initiated discussion of pregnancy intentions in the year before the index pregnancy (aRR = 0.63, 95% CI: 0.46 to 0.77, P < 0.01). Unplanned or ambivalent pregnancy was not associated with age, race/ethnicity, or educational level. CONCLUSIONS:: In this multisite US cohort, patient-initiated pregnancy counseling and being engaged in medical care before pregnancy were associated with a decreased probability of unplanned or ambivalent pregnancy. Interventions that promote healthcare engagement among HIV-infected women and integrate contraception and preconception counseling into routine HIV care may decrease the risk of unplanned pregnancy among HIV-infected women in the United States.

Copyright information:

Copyright © 2013 by Lippincott Williams & Wilkins.

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