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Predictors of pregnancy after HIV-positive diagnosis among women in western Jamaica

Authors Claye LJ, Sakhuja S, Nutt A, Aung M, Jolly PE

Received 20 February 2018

Accepted for publication 31 May 2018

Published 16 October 2018 Volume 2018:10 Pages 623—632


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Elie Al-Chaer

Lea Jean Claye,1 Swati Sakhuja,1 Ashley Nutt,1 Maung Aung,2 Pauline E Jolly1

1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; 2Epidemiology and Research Unit, Western Regional Health Authority, Ministry of Health, Montego Bay, Jamaica

Background: 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.
Objective: To describe the epidemiology and identify factors associated with pregnancy after HIV diagnosis among HIV-positive women in Western Jamaica.
Methods: 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.
Results: 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).
Conclusion: 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.

Keywords: pregnancy, HIV infection, desire for children, HIV disclosure

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