Reduced fertility among HIV-infected women. Results of cross-sectional and prospective studies in rural Uganda

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Abstract

Objectives: To assess the association between HJV infection, STDs and fertility in two studies from rural Uganda. Methods: Data were derived from two studies in Rakai District southwestern Uganda. These were: I) a cohort study of 3,502 women followed between 1990-93 with annual interview information on pregnancy and births; and 2) a study of 5.236 sexually active women enrolled during 1994-95 into an ongoing community-based clinical trial. In the latter study, pregnancy status was determined by interview and by urinary hCG tests. Laboratory samples were collected for other STDs including syphilis arid chancroid serology, chlamydia and gonorrhea (urinary "gase chain reaction), and trichomonas cuKures/BV gram stain from self-administered vaginal swabs. Results: In the cohort study, pregnancy rates per year among HIV + women were 14.456 compared to 17.7% in HIV- women (RR = 0.70. CI 0.58-0.84). In the clinical trial, pregnancy prevalence at enrollment Was 19.9% among women with no known STD. 14.5% in HlVnegative women with active syphilis. 11.3% in HIV + women and 7.7% among women with both HIV and syphilis.The reduced pregnancy prevalence in the HIV + was observed in symptomatic ( 10.0%) and asymptomatic women ( 12< I %). Current trichomonas, or chiamydia infections were not associated with reduced pregnancy prevalence. Muttivariate analyses show a significant reduction in the risk of pregnancy among HIV + subjects (RR = 0.47. 95% Q 0.37-0.59) after adjustment for age. STDs (including syphilis), contraceptive use. lactation and other covariates. Conception rates and rates of pregnancy loss are being assessed prospectively. Conclusions: H1V infection is associated with markedly reduced fertility in this rural population. This has implications for HIV surveillance through antenatal clinics, and projections of HIV infected infants, AIDS orphans and the demographic impact of the epidemic.

Original languageEnglish (US)
Number of pages1
JournalPediatric AIDS and HIV infection
Volume7
Issue number5
StatePublished - Dec 1 1996

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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