Reproductive Intentions and Outcomes among Women on Antiretroviral Therapy in Rural Uganda
Author Information
Author(s): Jaco Homsy, Rebecca Bunnell, David Moore, Rachel King, Samuel Malamba, Rose Nakityo, David Glidden, Jordan Tappero, Jonathan Mermin
Primary Institution: Centers for Disease Control and Prevention (CDC), Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Entebbe, Uganda
Hypothesis
How does antiretroviral therapy (ART) influence reproductive intentions and pregnancy outcomes among HIV-infected women in rural Uganda?
Conclusion
Women on ART and their partners should receive consistent counseling on the effects of ART on fertility and access to family planning services.
Supporting Evidence
- Pregnancy incidence increased from 3.46 per 100 women-years in the first quarter to 9.5 per 100 women-years at 24 months.
- Only 14% of women used permanent or semi-permanent family planning methods by their second year on ART.
- Young age and inconsistent condom use were independently associated with pregnancy.
Takeaway
This study looked at women with HIV in Uganda who were on treatment and found that even though many didn't want more children, pregnancies still happened.
Methodology
A prospective cohort study design was used to analyze trends in desire for children and predictors of pregnancy among 733 HIV-infected women on ART.
Potential Biases
Potential social desirability bias may have influenced women's reported desire for children.
Limitations
The study was not randomized, and there was variability in the spacing of interviews on sexual behavior.
Participant Demographics
Women aged 18-49, median age 37, with a majority being widowed and having multiple living children.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% CI: 2.95–3.78
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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