Predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care

Susie E. Huntington*, Claire Thorne, Loveleen K. Bansi, Jane Anderson, Marie Louise Newell, Graham P. Taylor, Deenan Pillay, Teresa Hill, Pat A. Tookey, Caroline A. Sabin

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    15 Citations (Scopus)

    Abstract

    Objectives: To describe predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care. Design: Data were obtained through the linkage of two separate studies: the UK Collaborative HIV Cohort study (UK CHIC), a cohort of adults attending 13 large HIV clinics; and the National Study of HIV in Pregnancy and Childhood (NSHPC), a national surveillance study of HIV-positive pregnant women. Pregnancy incidence was measured using the proportion of women in UK CHIC with a pregnancy reported to NSHPC. Generalized estimating equations were used to identify predictors of pregnancy and assess changes in pregnancy incidence in 2000-2009. Results: The number of women accessing care at UK CHIC sites increased as did the number of pregnancies. Older women were less likely to have a pregnancy [adjusted relative rate (aRR) 0.44 per 10 year increment in age, [95% confidence interval (CI) (0.41-0.46)], P<0.001] as were women with CD4 cell count less than 200cells/μl compared with CD4 cell count 200-350cells/μl [aRR 0.65 (0.55-0.77), P<0.001] and women of white ethnicity compared with women of black African ethnicity [aRR 0.67 (0.57-0.80), P<0.001]. The likelihood that women had a pregnancy increased over the study period [aRR 1.05 (1.03-1.07), P<0.001). The rate of change did not significantly differ according to age group, antiretroviral therapy use, CD4 group or ethnicity. Conclusion: The pregnancy rate among women accessing HIV clinical care increased in 2000-2009. HIV-positive women with, or planning, a pregnancy require a high level of care and this is likely to continue and increase as more women of older age have pregnancies.

    Original languageEnglish
    Pages (from-to)95-103
    Number of pages9
    JournalAIDS
    Volume27
    Issue number1
    DOIs
    Publication statusPublished - 2 Jan 2013

    Keywords

    • HAART
    • HIV
    • United Kingdom
    • maternal age
    • maternal-fetal infection transmission
    • pregnancy
    • pregnancy rate

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