Low receipt and uptake of safer conception messages in routine HIV care

Findings from a prospective cohort of women living with HIV in South Africa

Riley J. Steiner, Vivian Black, Helen Rees, Sheree Schwartz

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Safer conception strategies may be used by people living with HIV (PLWH) to reduce HIV transmission to partners resulting from condomless sex for conception. The extent to which PLWH receive safer conception messages and use risk reduction strategies is largely unknown. METHODS:: We use prospective data from a clinic-based cohort study in Johannesburg, South Africa. Women living with HIV (WLWH) aged 18-35 on antiretroviral therapy (n=831) completed a baseline survey and ≥1 follow-up visits assessing fertility intentions and pregnancy incidence; an endline survey was administered one year post-enrollment. Multivariate negative binomial regression models examined differences in the number of condomless sex acts by fertility intentions. Chi-squared statistics compared receipt of safer conception messages by fertility intentions, as well as indicators of safer conception method use by partner HIV status. RESULTS:: The median baseline age of participants was 30.4 years and 25.3% were in serodiscordant partnerships. WLWH trying to conceive were over three times more likely to have condomless sex compared to those not trying to conceive (aIRR: 3.17, 95%CI: 1.95-5.16). Receipt of specific safer conception messages was low, although women with positive fertility intentions were more likely to have received any fertility-related advice compared to those with unplanned pregnancies (76.3% vs. 49.1%, p

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
DOIs
StateAccepted/In press - Feb 5 2016

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South Africa
Fertility
HIV
Unplanned Pregnancy
Statistical Models
Risk Reduction Behavior
Cohort Studies
Pregnancy
Incidence

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

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title = "Low receipt and uptake of safer conception messages in routine HIV care: Findings from a prospective cohort of women living with HIV in South Africa",
abstract = "BACKGROUND:: Safer conception strategies may be used by people living with HIV (PLWH) to reduce HIV transmission to partners resulting from condomless sex for conception. The extent to which PLWH receive safer conception messages and use risk reduction strategies is largely unknown. METHODS:: We use prospective data from a clinic-based cohort study in Johannesburg, South Africa. Women living with HIV (WLWH) aged 18-35 on antiretroviral therapy (n=831) completed a baseline survey and ≥1 follow-up visits assessing fertility intentions and pregnancy incidence; an endline survey was administered one year post-enrollment. Multivariate negative binomial regression models examined differences in the number of condomless sex acts by fertility intentions. Chi-squared statistics compared receipt of safer conception messages by fertility intentions, as well as indicators of safer conception method use by partner HIV status. RESULTS:: The median baseline age of participants was 30.4 years and 25.3{\%} were in serodiscordant partnerships. WLWH trying to conceive were over three times more likely to have condomless sex compared to those not trying to conceive (aIRR: 3.17, 95{\%}CI: 1.95-5.16). Receipt of specific safer conception messages was low, although women with positive fertility intentions were more likely to have received any fertility-related advice compared to those with unplanned pregnancies (76.3{\%} vs. 49.1{\%}, p",
author = "Steiner, {Riley J.} and Vivian Black and Helen Rees and Sheree Schwartz",
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