HIV 感染者与非洲未感染 HIV 女性在接受终生抗逆转录病毒治疗后产后性生活和月经恢复情况的比较。
Resumption of postpartum sexual activity and menses among HIV-infected women on lifelong antiretroviral treatment compared to HIV-uninfected women in Africa.
机构信息
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Blantyre, Malawi.
出版信息
Int J Gynaecol Obstet. 2020 May;149(2):211-218. doi: 10.1002/ijgo.13113. Epub 2020 Mar 2.
OBJECTIVE
To determine time from delivery to resumption of sexual activity and menses among HIV-infected women on antiretroviral treatment (ART) and HIV-uninfected women.
METHODS
HIV-infected women on ART and HIV-uninfected women were recruited from five health facilities at delivery and followed prospectively for a maximum of 1 year in Blantyre, Malawi from January 2016 to September 2017. Sociodemographic, clinical, and laboratory data were collected at delivery and 1.5, 3, 6, 9, and 12 months. Descriptive, time to event Kaplan-Meier, and multivariable Cox proportional hazards analyses were conducted.
RESULTS
Data on 878 women (460 [52.4%] HIV-uninfected and 418 [47.6%] HIV-infected, P=0.156) who attended at least one follow-up visit were analyzed. Among HIV-uninfected compared to HIV-infected women, respectively, the median number of days to resumption of sexual activity was 180 vs 181; to irregular menses was 82 vs 71; and to regular menses was 245 vs 366. In multivariable models, being married was associated with early resumption of sexual activity (hazard ratio [HR] 1.91, P<0.001), and being HIV-infected and use of an effective method of family planning were associated with later start of regular menses (HR<1.0, P<0.050).
CONCLUSION
Counseling of women on reproductive intentions should start early irrespective of HIV infection or use of ART.
目的
确定接受抗逆转录病毒治疗（ART）的 HIV 感染妇女和 HIV 未感染妇女从分娩到恢复性生活和月经的时间。
方法
2016 年 1 月至 2017 年 9 月，在马拉维布兰太尔的五家卫生机构招募接受 ART 的 HIV 感染妇女和 HIV 未感染妇女，并在分娩后进行前瞻性随访，最长随访 1 年。在分娩时以及 1.5、3、6、9 和 12 个月收集社会人口统计学、临床和实验室数据。进行描述性、生存时间 Kaplan-Meier 分析和多变量 Cox 比例风险分析。
结果
对至少参加一次随访的 878 名妇女（460 名[52.4%]HIV 未感染和 418 名[47.6%]HIV 感染，P=0.156）的数据进行了分析。与 HIV 感染妇女相比，HIV 未感染妇女恢复性生活的中位天数分别为 180 天和 181 天；不规则月经为 82 天和 71 天；规律月经为 245 天和 366 天。在多变量模型中，已婚与性生活较早恢复有关（风险比[HR]1.91，P<0.001），而 HIV 感染和使用有效的计划生育方法与规律月经开始较晚有关（HR<1.0，P<0.050）。
结论
无论 HIV 感染或是否使用 ART，都应尽早开始对妇女进行生育意愿咨询。
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