Background Reproductive health in women with HIV (WWH) has improved in recent decades. We aimed to investigate incidences of childbirth, pregnancy, spontaneous abortion, and induced abortion among WWH in a nationwide, population-based, matched cohort study. Methods We included all WWH aged 20 to 40 treated at an HIV healthcare centre in Denmark from 1995-2021, and a matched comparison cohort of women from the general population (WGP). We calculated incidence rates per 1,000 person years and used Poisson regression to calculate adjusted incidence rate ratios (aIRR) of childbirth, pregnancy, spontaneous abortion, and induced abortion stratified according to calendar periods (1995-2001, 2002-2008, and 2009-2021). Results We included 1,288 WWH and 12,880 WGP. 46% of WWH were of African origin whereas 1% of WGP were of African origin. Compared to WGP, WWH had a decreased incidence of childbirth (aIRR: 0.6, 95% CI: 0.6-0.7), no difference in incidence of pregnancy (aIRR: 0.9, 95% CI: 0.8-1.0) or spontaneous abortion (aIRR: 0.9, 95% CI: 0.8-1.0), but an increased incidence of induced abortion (aIRR: 1.9, 95% CI: 1.6-2.1) from 1995-2021. The aIRR of childbirth, pregnancy, and spontaneous abortion increased from 1995-2000 to 2009-2021, while the aIRR of induced abortion remained increased across all time-periods for WWH. Conclusion From 1995-2008, incidences of childbirth, pregnancy, and spontaneous abortion were decreased among WWH compared to WGP. From 2009-2021, the incidence of childbirth, pregnancy, and spontaneous abortion no longer differed among WWH compared with WGP. The incidence of induced abortions remains increased among WWH.

Background HIV infection is associated with depression, but previous studies are imprecise and have not addressed familial factors. Methods Nationwide, population-based matched cohort study of people with HIV (PWH) in Denmark between 1995 and 2021, matched on sex and date of birth with a comparison cohort randomly selected from the Danish population. Aditionally, family related factors were examined by inclusion of siblings of these cohorts. We calculated hazard ratios (HR) for depression, receipt of antidepressants, electroconvulsive therapy (ECT), and suicide and yearly proportions of study cohorts with psychiatric hospital contact due to depression and receipt of antidepressants from 10 years before to 10 years after study inclusion. Results We included 5,943 PWH and 59,430 comparison cohort members. Median age was 38 years and 25% were women. We observed an increased risk of depression, receipt of antidepressants, ECT, and suicide among PWH in the 2 first years of observation (HR of 3.3 (95% CI: 2.5-4.4), 3.0 (95% CI: 2.7-3.4), 2.8 (95% CI: 0.9-8.6) and 10.7 (95% CI: 5.2-22.2)), thereafter the risk subsided, but remained increased. The proportions of PWH with psychiatric hospital contact due to depression and receipt of antidepressants were increased prior to-, and especially after HIV diagnosis. Risk of all outcomes were substantially lower among siblings of PWH than among PWH (HR for receipt of antidepressants was 1.1 (95% CI: 1.0-1.2)). Conclusion PWH have an increased risk of depression, especially in the first 2 years after HIV diagnosis. Family related factors are unlikely to explain this risk.