Abstract
High fertility intentions amongst HIV-positive women have been reported elsewhere. Less is known about how clinical and HIV treatment characteristics correlate with fertility intentions. We use cross-sectional baseline data from a prospective cohort study to assess pregnancy intentions and patient–provider communication around fertility. Non-pregnant, HIV-positive women aged 18–35 on ART were recruited through convenience sampling at Johannesburg antiretroviral (ART) treatment facilities. Among the 850 women in this analysis, those on efavirenz had similar fertility intentions over the next year as women on nevirapine-based regimens (33% vs. 38%). In multivariate analysis, recent ART initiation was associated with higher current fertility intentions; there was no association with CD4 cell count. Forty-one percent of women had communicated with providers about future pregnancy options. Women on ART may choose to conceive at times that are sub-optimal for maternal, child and partner health outcomes and should be routinely counseled around safer pregnancy options.
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Acknowledgments
We thank all of our participants for sharing their time and experiences and the study staff for their efforts and dedication to the participants. The Pregnancy Intentions and Incidence Study is supported by the Wits Reproductive Health & HIV Institute at the University of the Witwatersrand and the United States Centers for Disease Control (CDC) public health dissertation grant 1R36PS001584-01. SS received support from grant 1R36PS001584-01, the Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology Doctoral Student Fund and the Johns Hopkins Bloomberg School of Public Health, Global Field Experience Fund. Our research was conducted in clinics supported by PEPFAR and the United States Agency for International Development. All authors contributed to the study design. SS and VB oversaw data collection. SS conducted the analysis with assistance from SM and TT. SS drafted the manuscript and all authors contributed substantially to the editing of the manuscript. Some parts of this analysis were presented in posters at the International AIDS Society Conference in Vienna, Austria (July 2010).
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Schwartz, S.R., Mehta, S.H., Taha, T.E. et al. High Pregnancy Intentions and Missed Opportunities for Patient–Provider Communication About Fertility in a South African Cohort of HIV-Positive Women on Antiretroviral Therapy. AIDS Behav 16, 69–78 (2012). https://doi.org/10.1007/s10461-011-9981-3
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DOI: https://doi.org/10.1007/s10461-011-9981-3