Unplanned Pregnancies Among HIV-Infected Women in CareUnited States

Sutton, Madeline Y. MD, MPH*; Patel, Roshni MPH*,†; Frazier, Emma L. PhD, MS*

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000054
Epidemiology and Prevention
Abstract

Objective: To examine the prevalence of unplanned pregnancies among HIV-infected women in care in the United States.

Methods: We used the 2007–2008 cycles of the Medical Monitoring Project, which collected data on HIV-infected adults in care. Women were included if they had an HIV diagnosis before 45 years of age and responded to questions about pregnancies and pregnancy planning after HIV diagnosis. Logistic regression was used to calculate unadjusted and adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for correlates of unplanned pregnancies among women with ≥1 pregnancy at or after an HIV diagnosis.

Results: Of 1492 women, 382 (25.6%) reported ≥1 pregnancy after HIV diagnosis (median diagnosis age = 25.0 years; interquartile range = 21.0–30.0); 58% were non-Hispanic black, 22% Hispanic, and 15% non-Hispanic white. Of those, 326 (85.3%) reported ≥1 unplanned pregnancy; 124 (32.5%) reported recent unprotected vaginal and/or anal sex with a male partner with either negative or unknown HIV status. Unplanned pregnancies were more likely among women who reported nadir CD4 cell counts <200 cells/μL (AOR = 2.3; 95% CI: 1.2 to 4.8) or did not report nadir CD4 cell counts (AOR = 4.3; 95% CI: 1.9 to 10.5) compared with women who reported nadir CD4 cell counts ≥200 cells/μL; and who received public assistance in the most recent year before Medical Monitoring Project interview (AOR = 2.1; 95% CI: 1.1 to 3.8) compared with women who did not receive assistance.

Conclusions: Unplanned pregnancies were prevalent among our sample. To avoid unplanned pregnancies, HIV-infected women need access to effective family planning services and risk reduction discussions during routine care visits.

Author Information

*Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and

ICF International, Atlanta, GA.

Correspondence to: Madeline Y. Sutton, MD, MPH, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE MS E-45, Atlanta, GA 30333 (e-mail: msutton@cdc.gov).

Supported by CDC.

The authors have no conflicts of interest to disclose.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Received October 25, 2013

Accepted October 25, 2013

© 2014 by Lippincott Williams & Wilkins