1. Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa.
- Author
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Johnson, Leigh F, Mutemaringa, Themba, Heekes, Alexa, and Boulle, Andrew
- Subjects
HIV infections ,HIV ,PROPORTIONAL hazards models ,PREGNANCY ,HIV infection epidemiology ,COMMUNICABLE disease epidemiology ,ANTI-HIV agents ,FAMILY planning ,COMMUNICABLE diseases ,BIRTH rate ,DISEASE incidence ,PREGNANCY complications ,QUESTIONNAIRES ,MEDICAL needs assessment - Abstract
Background: Previous studies suggest that untreated human immunodeficiency virus (HIV) infection is associated with a reduced incidence of pregnancy, but studies of the effect of antiretroviral treatment (ART) on pregnancy incidence have been inconsistent.Methods: Routine data from health services in the Western Cape province of South Africa were linked to identify pregnancies during 2007-2017 and maternal HIV records. The time from the first (index) pregnancy outcome date to the next pregnancy was modeled using Cox proportional hazards models.Results: During 2007-2017, 1 042 647 pregnancies were recorded. In all age groups, pregnancy incidence rates were highest in women who had started ART, lower in HIV-negative women, and lowest in ART-naive HIV-positive women. In multivariable analysis, after controlling for the most recent CD4+ T-cell count, pregnancy incidence rates in HIV-positive women receiving ART were higher than those in untreated HIV-positive women (adjusted hazard ratio, 1.63; 95% confidence interval, 1.59-1.67) and those in HIV-negative women.Conclusion: Among women who have recently been pregnant, receipt of ART is associated with high rates of second pregnancy. Better integration of family planning into HIV care services is needed. [ABSTRACT FROM AUTHOR]- Published
- 2020
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