AIDS and Behavior

, Volume 14, Issue 5, pp 1066–1071

Predicting Pregnancy in HIV-1-Discordant Couples

  • Brandon L. Guthrie
  • Robert Y. Choi
  • Rose Bosire
  • James N. Kiarie
  • Romel D. Mackelprang
  • Anne Gatuguta
  • Grace C. John-Stewart
  • Carey Farquhar
Report

Abstract

This study examines the incidence and predictors of pregnancy in HIV-1-discordant couples from Nairobi, Kenya. Women from 454 discordant couples were followed for up to 2 years. One-year cumulative incidence of pregnancy was 9.7%. Pregnancy rates did not differ significantly between HIV-1-infected and uninfected women (HR = 1.46). The majority of pregnancies occurred among women < 30 years old reporting a desire for future children (1-year incidence 22.2%). Pregnancy rates may be high among discordant couples, indicating desire for children may override concerns of HIV-1 transmission and increase unprotected sex, and highlighting the need to make conception safer.

Keywords

HIV Discordant couples Serodiscordant Pregnancy Predictors Risk factor 

References

  1. 1.
    Allen S, Meinzen-Derr J, Kautzman M, et al. Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS. 2003;17(5):733–40.CrossRefPubMedGoogle Scholar
  2. 2.
    Myer L, Morroni C, Rebe K. Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa. AIDS Patient Care STDS. 2007;21(4):278–85.CrossRefPubMedGoogle Scholar
  3. 3.
    Brubaker S, Bukusi EA, Odoyo J, Achando J, Okumu A, Cohen C. Pregnancy and HIV transmission among HIV discordant couples in a clinical trial in Kisumu, Kenya. 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Cape Town, South Africa; 2009 [abstract WELBC105].Google Scholar
  4. 4.
    Gray RH, Li X, Kigozi G, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Moodley D, Esterhuizen TM, Pather T, Chetty V, Ngaleka L. High HIV incidence during pregnancy: compelling reason for repeat HIV testing. AIDS. 2009;23(10):1255–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Volmink J, Siegfried N, van der Merwe L, Brocklehurst P. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev. 2007;(1):CD003510. doi:10.1002/14651858.CD003510.pub2.
  7. 7.
    Bujan L, Hollander L, Coudert M, et al. Safety and efficacy of sperm washing in HIV-1-serodiscordant couples where the male is infected: results from the European CREAThE network. AIDS. 2007;21(14):1909–14.CrossRefPubMedGoogle Scholar
  8. 8.
    Lingappa JR, Kahle E, Mugo N, Mujugira A, Magaret A, et al. Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study. PLoS ONE. 2009;4(4):e5272. doi:10.1371/journal.pone.0005272.CrossRefPubMedGoogle Scholar
  9. 9.
    Guthrie BL, de Bruyn G, Farquhar C. HIV-1-discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Curr HIV Res. 2007;5(4):416–29.CrossRefPubMedGoogle Scholar
  10. 10.
    Bunnell R, Ekwaru JP, Solberg P, Wamai N, Bikaako-Kajura W, Were W, et al. Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS. 2006;20(1):85–92.CrossRefPubMedGoogle Scholar
  11. 11.
    Homsy J, Bunnell R, Moore D, King R, Malamba S, et al. Reproductive intentions and outcomes among women on antiretroviral therapy in rural Uganda: a prospective cohort study. PLoS ONE. 2009;4(1):e4149. doi:10.1371/journal.pone.0004149.CrossRefPubMedGoogle Scholar
  12. 12.
    Reid SE, Dai JY, Wang J, et al. Pregnancy, contraceptive use, and HIV acquisition in HPTN 039: relevance for HIV prevention trials among African women. J Acquir Immune Defic Syndr. 2010;53(5):606–13.PubMedGoogle Scholar
  13. 13.
    Taulo F, Berry M, Tsui A, et al. Fertility intentions of HIV-1 infected and uninfected women in Malawi: a longitudinal study. AIDS Behav. 2009;13(Suppl 1):20–7.CrossRefPubMedGoogle Scholar
  14. 14.
    US Census Bureau IPC, Global population profile. International database: age-specific fertility rates and selected derived measures. 2010.Google Scholar
  15. 15.
    Matthews LT, Mukherjee JS. Strategies for harm reduction among HIV-affected couples who want to conceive. AIDS Behav. 2009;13(Suppl 1):5–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Brandon L. Guthrie
    • 1
  • Robert Y. Choi
    • 2
  • Rose Bosire
    • 4
  • James N. Kiarie
    • 5
  • Romel D. Mackelprang
    • 1
  • Anne Gatuguta
    • 6
  • Grace C. John-Stewart
    • 1
    • 2
    • 3
  • Carey Farquhar
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Department of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of Global HealthUniversity of WashingtonSeattleUSA
  4. 4.Centre for Public Health ResearchKenya Medical Research InstituteNairobiKenya
  5. 5.Department of Obstetrics and GynaecologyUniversity of NairobiNairobiKenya
  6. 6.Department of Community HealthUniversity of NairobiNairobiKenya

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