Birth outcomes in perinatally HIV-infected adolescents and young adults in Manipur, India: a new frontier

Chibber, Rachana; A, Khurranna

doi:10.1007/s00404-003-0564-z

Cited by 29 publications

(24 citation statements)

References 8 publications

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“…This is consistent with previous studies [9,11,12,16] and with pregnancies in HIV-infected adults from the UK and Ireland [17]. The overall HIV mother-to-child transmission rate was 1.5%.…”

Section: Discussionsupporting

confidence: 91%

Pregnancy in HIV-infected teenagers in London

et al. 2010

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There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started postconception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (o37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again. ConclusionObstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed. Studies exploring pregnancy in HIV-infected adolescents are limited. The largest described 1183 live births in 1090 pregnant adolescents in the United States, the majority of whom had acquired HIV infection sexually [11]. Most pregnancies were unplanned (83%) and occurred in teenagers who had previously been pregnant (67%).A prospective cohort study of 638 vertically infected girls, again in the USA, reported 45 pregnancies, with 17% of girls experiencing a first pregnancy by their 19th birthday [8]. Of the 32 pregnancies resulting in live births, one infant was HIV-infected, 29 were uninfected and two had unknown infection status. Chibber and Khurranna also reported favourable obstetric outcomes and no cases of vertical transmission in a study of 30 pregnant vertically infected adolescents in India [12]. Other case series have described similar findings [13][14][15]. In a small European study, there were nine live births with no mother-to-child transmissions [16]. To date there have been no studies in the UK looking at pregnancy in teenagers living with HIV.In this study we reviewed the pregnancies of 58 HIVinfected teenagers attending for care at 12 London hospitals. We explore the medical and social features of this group and describe their sexual and reproductive health issues, their response to antiretroviral therapy (ART) and pregnancy outcome. MethodsWe conducted a retrospective case note review of HIVinfected pregnant female patients aged between 13 and...

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“…This is consistent with previous studies [9,11,12,16] and with pregnancies in HIV-infected adults from the UK and Ireland [17]. The overall HIV mother-to-child transmission rate was 1.5%.…”

Section: Discussionsupporting

confidence: 91%

Pregnancy in HIV-infected teenagers in London

et al. 2010

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“…[4][5][6][7] Unequivocal evidence of sexual behavior and inconsistent condom use among vertically HIV-infected adolescents has emerged in the form of pregnancies among vertically HIV-infected girls. [8][9][10][11] Surveys of Thai adolescents have also revealed high rates of risk-taking behaviors. More than 40% have reported sexual intercourse, but only 16% and 11% of sexually active males and females, respectively, have reported consistent condom use.…”

Section: Introductionmentioning

confidence: 99%

Risk-Taking Behaviors Among Vertically HIV-Infected Adolescents in Northern Thailand

Lee

Oberdorfer

2009

Journal of the International Association of Physicians in AIDS

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Purpose. To examine risk-taking behaviors and HIV self-disclosure among vertically HIV-infected adolescents in northern Thailand. Methods. A quantitative survey was conducted from 2007 to 2008 at 2 pediatric HIV clinics in northern Thailand among vertically HIV-infected adolescents aged ≥13 years, with disclosed HIV status. The survey assessed sociodemographics, substance use, sexual behavior, peer behaviors, knowledge, and attitudes regarding HIV disclosure. Results. Fifty-four adolescents (median age 14.6 years) participated; 18.5% reported previous alcohol use but none reported drug use; 35.2% reported presexual activity, and 3.7% reported sexual activity. Nearly all (96.3%) knew that HIV could be transmitted sexually, but knowledge regarding other sexually transmitted infections (STIs) was poor. Nearly half (48.1%) had never disclosed their status to anyone. Conclusions. Rates of substance use and sexual activity were low in this population. STI knowledge was poor and diagnosis self-disclosure was infrequent. Improved sexual education and self-disclosure skills are needed among vertically HIV-infected adolescents in Thailand.

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“…A growing number of reports have confirmed the increasing occurrence of pregnancy, which appears to be unplanned in a substantial proportion of cases, among perinatally infected young women with HIV (Brogly et al, 2007;Centers for Disease Control and Prevention, 2002;Chibber & Khurranna, 2005;Koenig, Espinoza, Hodge & Ruffo, 2007;Thorne, Townsend, Peckham, Newell & Tookey, 2007). We report two cases of vertically infected HIV-positive adolescents, referred for pregnancy to our…”

Section: Introductionmentioning

confidence: 77%