Impact of Antiretroviral Therapy on Incidence of Pregnancy among HIV-Infected Women in Sub-Saharan Africa: A Cohort Study
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{"title"=>"Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: A cohort study", "type"=>"journal", "authors"=>[{"first_name"=>"Landon", "last_name"=>"Myer", "scopus_author_id"=>"7006272201"}, {"first_name"=>"Rosalind J.", "last_name"=>"Carter", "scopus_author_id"=>"8291470700"}, {"first_name"=>"Monica", "last_name"=>"Katyal", "scopus_author_id"=>"9745517100"}, {"first_name"=>"Patricia", "last_name"=>"Toro", "scopus_author_id"=>"14061220500"}, {"first_name"=>"Wafaa M.", "last_name"=>"El-Sadr", "scopus_author_id"=>"56751023900"}, {"first_name"=>"Elaine J.", "last_name"=>"Abrams", "scopus_author_id"=>"7006446161"}], "year"=>2010, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-77649107299", "pui"=>"358373278", "doi"=>"10.1371/journal.pmed.1000229", "isbn"=>"1549-1277", "sgr"=>"77649107299", "pmid"=>"20161723"}, "id"=>"097dcd71-6779-3bfd-82e7-ac080ab95e8d", "abstract"=>"BACKGROUND With the rapid expansion of antiretroviral therapy (ART) services in sub-Saharan Africa there is growing recognition of the importance of fertility and childbearing among HIV-infected women. However there are few data on whether ART initiation influences pregnancy rates. METHODS AND FINDINGS We analyzed data from the Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative, a multicountry HIV care and treatment program for women, children, and families. From 11 programs in seven African countries, women were enrolled into care regardless of HIV disease stage and followed at regular intervals; ART was initiated according to national guidelines on the basis of immunological and/or clinical criteria. Standardized forms were used to collect sociodemographic and clinical data, including incident pregnancies. Overall 589 incident pregnancies were observed among the 4,531 women included in this analysis (pregnancy incidence, 7.8/100 person-years [PY]). The rate of new pregnancies was significantly higher among women receiving ART (9.0/100 PY) compared to women not on ART (6.5/100 PY) (adjusted hazard ratio, 1.74; 95% confidence interval, 1.19-2.54). Other factors independently associated with increased risk of incident pregnancy included younger age, lower educational attainment, being married or cohabiting, having a male partner enrolled into the program, failure to use nonbarrier contraception, and higher CD4 cell counts. CONCLUSIONS ART use is associated with significantly higher pregnancy rates among HIV-infected women in sub-Saharan Africa. While the possible behavioral or biomedical mechanisms that may underlie this association require further investigation, these data highlight the importance of pregnancy planning and management as a critical but neglected component of HIV care and treatment services. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/impact-antiretroviral-therapy-incidence-pregnancy-among-hivinfected-women-subsaharan-africa-cohort-s-4", "reader_count"=>88, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>3, "Researcher"=>12, "Student > Doctoral Student"=>7, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>10, "Student > Master"=>18, "Other"=>9, "Student > Bachelor"=>10, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>3, "Researcher"=>12, "Student > Doctoral Student"=>7, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>10, "Student > Master"=>18, "Other"=>9, "Student > Bachelor"=>10, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Environmental Science"=>1, "Nursing and Health Professions"=>12, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>41, "Agricultural and Biological Sciences"=>3, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Chemistry"=>1, "Psychology"=>3, "Social Sciences"=>14, "Immunology and Microbiology"=>1, "Earth and Planetary Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>41}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>14}, "Psychology"=>{"Psychology"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>12}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>8}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"United States"=>1, "South Africa"=>1, "Nigeria"=>1, "Ethiopia"=>1}, "group_count"=>6}

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Figshare

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PMC Usage Stats | Further Information

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