Fetal and placental growth disorders are common in maternal human immunodeficiency virus (HIV) infection and can be attributed to both the infection and comorbidities not associated with HIV. We describe placental growth disorders and adverse reproductive outcomes in HIV-infected pregnant women whose delivery occurred between 2001-2014 in Vitoria, Brazil. Cases with gestational age (GA) � than 22 weeks validated by ultrasonography, with placental and fetal weight dimensions at birth, were studied. Outcomes were summarized as proportions of small (SGA), appropriate (AGA), and large (LGA) for GA when the z-score values were below-1.28, between-1.28 and +1.28, or above +1.28, respectively. Of 187 fetal attachment requisitions, 122(65.2%) women and their newborns participated in the study. The median maternal age was 28 years and 81(66.4%) underwent � 6 prenatal visits. A total of 81(66.4%) were diagnosed before current pregnancy; 68(55.7%) exhibited criteria for acquired immunodeficiency syndrome (AIDS); 64(52.4%) had detectable viral load; 25 (20.5%) cases presented SGA placental weight and 6(4.9%) SGA placental thickness. SGA placental area was observed in 41(33.6%) cases, and among the SGA placental weight cases 12(48%) were also SGA fetal weight. Preterm birth (PTB) occurred in 15.6%(19/122) of cases; perinatal death in 4.1%(5/122) and HIV vertical transmission in 6 of 122 (4.9%). Women, �36 years old, were 5.7 times more likely to have PTB than those under 36. Also, patients with AIDS-defining criteria were 3.7 times more likely to have PTB. Prenatal care was inversely associated with PTB. Statistically significant associations were observed between AGA placental area and Protease Inhibitor usage and between SGA placental weight and SGA area. We found a prevalence of placental growth disorders in HIV-infected pregnant women and values higher than international reference values. The restriction of placental growth was a common disorder, possibly attributed to virus effects or a combination of antiretroviral regimens.

Background Nigeria has the second highest global prevalence of Human Immunodeficiency Virus (HIV), with over two million children (0-17 years) made vulnerable by HIV, having lost either or both parents to Acquired Immune Deficiency Syndrome (AIDS). The Association for Reproductive and Family Health (ARFH) is implementing a five year Local Partners for Orphans and Vulnerable Children (OVC) Project in Nigeria, with support from the United States Agency for International Development (USAID), to mitigate the impact of HIV/AIDS on children and vulnerable households, in Lagos State. Poverty remains a major driver of HIV in Nigeria. Methods Strategies include HIV Risk Assessments, Assisted Referrals and incentivized enrollment. The Community Volunteers (CVs) accompany those referred for HIV Testing Services (HTS) to health facilities, results are collected and HIV positives are counselled and linked to treatment same day. Incentivized enrollment on treatment is for indigent enrollees, to promote retention. The sum of $25 is provided in three equal instalments as coupons, redeemed on producing evidence of enrollment on treatment, and two subsequent drug refills.