Claye Lea Jean, Sakhuja Swati, Nutt Ashley, Aung Maung, Jolly Pauline E
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA,
Epidemiology and Research Unit, Western Regional Health Authority, Ministry of Health, Montego Bay, Jamaica.
Int J Womens Health. 2018 Oct 16;10:623-632. doi: 10.2147/IJWH.S165958. eCollection 2018.
Antiretroviral therapy has minimized mother-to-child transmission of HIV and given hope to HIV-positive women considering pregnancy. In Jamaica, 36% of HIV-positive pregnant women enrolled in a pediatric/perinatal HIV/AIDS program had repeat pregnancies.
To describe the epidemiology and identify factors associated with pregnancy after HIV diagnosis among HIV-positive women in Western Jamaica.
A cross-sectional study was designed among HIV-positive women 18-54 years old who either had or did not have at least one pregnancy after HIV-positive diagnosis. A questionnaire was used to collect information on sociodemographic factors and health-seeking, reproductive, and sexual risk behaviors.
A total of 219 HIV-positive women participated in this study. Length of time since HIV diagnosis, CD4 count, and birth-control methods used were significant predictors of pregnancy after HIV diagnosis. Women diagnosed with HIV <5 years previously had lower odds for pregnancy after HIV diagnosis (adjusted OR 0.12, 95% CI 0.02-0.84) compared to those who had been diagnosed ≥8 years previously. Women with CD4 count <350 were over six times as likely to have a pregnancy after HIV diagnosis (adjusted OR 6.94, 95% CI 1.18-40.66). The odds for pregnancy after HIV diagnosis for a woman decreased by 93% if her children shared the same father (adjusted OR 0.07, 95% CI 0.006-0.77).
This study identified significant predictors of pregnancy after HIV diagnosis that indicate that integrative family-planning interventions with supportive reproductive counseling are likely to help HIV-positive women obtain early appropriate care and plan the pregnancies they desire.
抗逆转录病毒疗法已将母婴传播的艾滋病毒感染率降至最低，并给考虑怀孕的艾滋病毒阳性女性带来了希望。在牙买加，参加儿科/围产期艾滋病毒/艾滋病项目的艾滋病毒阳性孕妇中有36%再次怀孕。
描述牙买加西部艾滋病毒阳性女性在艾滋病毒诊断后怀孕的流行病学情况，并确定与之相关的因素。
对18至54岁的艾滋病毒阳性女性进行了一项横断面研究，这些女性在艾滋病毒诊断后有或没有至少一次怀孕经历。通过问卷调查收集社会人口学因素以及寻求医疗、生殖和性风险行为方面的信息。
共有219名艾滋病毒阳性女性参与了本研究。自艾滋病毒诊断后的时间长度、CD4细胞计数以及所采用的避孕方法是艾滋病毒诊断后怀孕的重要预测因素。与那些在8年及以上以前被诊断出艾滋病毒的女性相比，在5年以内被诊断出艾滋病毒的女性在艾滋病毒诊断后怀孕的几率较低（校正比值比为0.12，95%置信区间为0.02 - 0.84）。CD4细胞计数低于350的女性在艾滋病毒诊断后怀孕的可能性是前者的6倍多（校正比值比为6.94，95%置信区间为1.18 - 40.66）。如果孩子有同一个父亲，艾滋病毒诊断后怀孕的几率会降低93%（校正比值比为0.07，95%置信区间为0.006 - 0.77）。
本研究确定了艾滋病毒诊断后怀孕的重要预测因素，这表明综合计划生育干预措施以及支持性的生殖咨询可能有助于艾滋病毒阳性女性获得早期适当护理，并规划她们期望的怀孕。
