Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women

Haddad, Lisa; Wall, Kristin M.; Mehta, C. Christina; Golub, Elizabeth T.; Rahangdale, Lisa; Kempf, Mirjam Colette; Karim, Roksana; Wright, Rodney; Minkoff, Howard; Cohen, Mardge H.; Kassaye, Seble; Cohan, Deborah; Ofotokun, Igho; Cohn, Susan E.

doi:10.1016/j.ajog.2016.09.079

Cited by 43 publications

(48 citation statements)

References 31 publications

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“…I n the current combined antiretroviral treatment (cART) era, pregnancy rates have increased among US women with HIV and are comparable with women without HIV. 1 Miscarriage occurs in an estimated 10e20% of US women. 2e4 However, relatively little is known about the frequency and factors associated with miscarriage among women living with HIV (WLHIV).…”

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confidence: 99%

Miscarriage among women in the United States Women’s Interagency HIV Study, 1994–2017

Wall

Haddad

Mehta

et al. 2019

American Journal of Obstetrics and Gynecology

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BACKGROUND: Relatively little is known about the frequency and factors associated with miscarriage among women living with HIV. OBJECTIVE: The objective of the study was to evaluate factors associated with miscarriage among women enrolled in the Women's Interagency HIV Study. STUDY DESIGN: We conducted an analysis of longitudinal data collected from Oct. 1, 1994, to Sept. 30, 2017 Women who attended at least 2 Women's Interagency HIV Study visits and reported pregnancy during follow-up were included. Miscarriage was defined as spontaneous loss of pregnancy before 20 weeks of gestation based on self-report assessed at biannual visits. We modeled the association between demographic, behavioral, and clinical covariates and miscarriage (vs live birth) for women overall and stratified by HIV status using mixed-model logistic regression. RESULTS: Similar proportions of women living with and without HIV experienced miscarriage (37% and 39%, respectively, P ¼ .638). In adjusted analyses, smoking tobacco (adjusted odds ratio, 2.0), alcohol use (adjusted odds ratio, 4.0), and marijuana use (adjusted odds ratio, 2.0) were associated with miscarriage. Among women living with HIV, low HIV viral load (<4 log10 copies/mL) (adjusted odds ratio, 0.5) and protease inhibitor (adjusted odds ratio, 0.4) vs the nonuse of combination antiretroviral therapy use were protective against miscarriage. CONCLUSION: We did not find an increased odds of miscarriage among women living with HIV compared with uninfected women; however, poorly controlled HIV infection was associated with increased miscarriage risk. Higher miscarriage risk among women exposed to tobacco, alcohol, and marijuana highlight potentially modifiable behaviors. Given previous concern about antiretroviral therapy and adverse pregnancy outcomes, the novel protective association between protease inhibitors compared with nonecombination antiretroviral therapy and miscarriage in this study is reassuring.

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confidence: 99%

Miscarriage among women in the United States Women’s Interagency HIV Study, 1994–2017

Wall

Haddad

Mehta

et al. 2019

American Journal of Obstetrics and Gynecology

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“…In the United States, pregnancy and live-birth rates among women living with HIV have increased, with rates now being similar to those of uninfected women [7]. Furthermore, higher pregnancy rates among women living with HIV are associated with ART use and improved immune status.…”

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Parenting Desires Among Individuals Living With Human Immunodeficiency Virus in the United States

Cohn

Haddad

Sheth

et al. 2018

Open Forum Infectious Diseases

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BackgroundIn 1988, 1 of 3 women (W) and heterosexual men living with human immunodeficiency virus (HIV) reported wanting children, but little is known about parenting desires of men who have sex with men (MSM) living with HIV. We examined parenting desires among persons initiating antiretroviral therapy (ART).MethodsOf 1809 participants in the AIDS Clinical Trials Group (ACTG) Study 5257, 1425 W aged ≤45 years or men completed questionnaires about parenting desires at baseline and 96 weeks after initiating ART. Self-reported desires for children in the future (yes/unsure vs no) and associations between baseline sociodemographics and parenting desires at 96 weeks were examined using multivariable logistic regression, overall and within subgroups.ResultsThe 1425 participants were as follows: 36% white, 39% black, 22% Hispanic; median age 36 (interquartile range, 28–44); 70% MSM, 13% men reported sex only with W (MSW), 17% W. At baseline, 42% may want children in the future (42% MSM, 37% MSW, 43% W); at 96 weeks, 41% may want children (41% MSM, 37% MSW, 43% W). At follow-up, approximately 10% of responses changed in each direction. In multivariable analyses, education greater than high school, <30 years, and having no children were significantly associated with future parenting desires among all subgroups. Among MSM, being black was associated with desiring children.ConclusionsApproximately 40% of MSM, W, and MSW with HIV may want children, both at baseline and 96 weeks after ART initiation. These results highlight the need to regularly assess parenting goals, provide access to comprehensive reproductive services, and address prevention of vertical and heterosexual HIV transmission.

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“…In Uganda, a sub-Saharan Africa country, about one-third of WLWH were pregnant within three years of ART initiation [11]. Socio-economic and demographic factors that could influence pregnancy or birth after HIV diagnosis include age at diagnosis [8,15], duration since HIV diagnosis [6,8], marital status [16], working status and parity [17]. With a total fertility rate of 5.3 births per woman [18] in Nigeria, and barely 50% ART access among people living with HIV, information on FBI_HIV is rare.…”

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Semi-parametric model for timing of first childbirth after HIV diagnosis among women of childbearing age in Ibadan, Nigeria

Akinyemi¹,

Afolabi²,

Awolude³

2020

PLoS ONE

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Background HIV diagnosis is a watershed in women's childbearing experience. It is usually accompanied by the fear of death and stigmatisation. Women diagnosed of HIV are often sceptical about pregnancy. Meanwhile, availability of antiretroviral treatments has impacted positively on childbearing experience among women living with HIV. We therefore investigated the timing of first childbirth after HIV diagnosis and its determinants among women in Ibadan, Nigeria. Methods We extracted and analysed data from a 2015 cross-sectional study on childbearing progression among 933 women living with HIV and receiving care at

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Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women

Cited by 43 publications

References 31 publications

Miscarriage among women in the United States Women’s Interagency HIV Study, 1994–2017

Miscarriage among women in the United States Women’s Interagency HIV Study, 1994–2017

Parenting Desires Among Individuals Living With Human Immunodeficiency Virus in the United States

Semi-parametric model for timing of first childbirth after HIV diagnosis among women of childbearing age in Ibadan, Nigeria

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