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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Increased risk of HIV-1 transmission in pregnancy: A prospective study among African HIV-1-serodiscordant couples
AIDS, Volume 25, No. 15, Year 2011
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Description
BACKGROUND: Physiologic and behavioral changes during pregnancy may alter HIV-1 susceptibility and infectiousness. Prospective studies exploring pregnancy and HIV-1 acquisition risk in women have found inconsistent results. No study has explored the effect of pregnancy on HIV-1 transmission risk from HIV-1-infected women to male partners. METHODS: In a prospective study of African HIV-1-serodiscordant couples, we evaluated the relationship between pregnancy and the risk of HIV-1 acquisition among women and HIV-1 transmission from women to men. RESULTS: Three thousand three hundred and twenty-one HIV-1-serodiscordant couples were enrolled, 1085 (32.7%) with HIV-1 susceptible female partners and 2236 (67.3%) with susceptible male partners. HIV-1 incidence in women was 7.35 versus 3.01 per 100person-years during pregnant and nonpregnant periods [hazard ratio 2.34, 95% confidence interval (CI) 1.33-4.09]. This effect was attenuated and not statistically significant after adjusting for sexual behavior and other confounding factors (adjusted hazard ratio 1.71, 95% CI 0.93-3.12). HIV-1 incidence in male partners of infected women was 3.46 versus 1.58 per 100person-years when their partners were pregnant versus not pregnant (hazard ratio 2.31, 95% CI 1.22-4.39). This effect was not attenuated in adjusted analysis (adjusted hazard ratio 2.47, 95% CI 1.26-4.85). CONCLUSION: HIV-1 risk increased two-fold during pregnancy. Elevated risk of HIV-1 acquisition in pregnant women appeared in part to be explained by behavioral and other factors. This is the first study to show that pregnancy increased the risk of female-to-male HIV-1 transmission, which may reflect biological changes of pregnancy that could increase HIV-1 infectiousness. © 2011 Wolters Kluwer Health | Lippincott Williams &Wilkins.
Authors & Co-Authors
Mugo, Nelly Rwamba
Kenya, Nairobi
University of Nairobi College of Health Sciences
Kenya, Nairobi
University of Nairobi
United States, Seattle
University of Washington
Heffron, Renee A.
United States, Seattle
University of Washington
Donnell, Deborah J.
United States, Seattle
Fred Hutchinson Cancer Research Center
Wald, Anna
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Were, Edwin O.
Kenya, Eldoret
Moi University
Rees, Helen V.
South Africa, Johannesburg
University of the Witwatersrand
Celum, Connie L.
United States, Seattle
University of Washington
Kiarie, James Njogu
Kenya, Nairobi
University of Nairobi College of Health Sciences
Kenya, Nairobi
University of Nairobi
United States, Seattle
University of Washington
Cohen, Craig R.
United States, San Francisco
University of California, San Francisco
Kayintekore, Kayitesi
Rwanda, Kigali
Rwanda Zambia Hiv Research Group
Baeten, Jared M.
United States, Seattle
University of Washington
Statistics
Citations: 271
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1097/QAD.0b013e32834a9338
e-ISSN:
14735571
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Male
Female