TY - JOUR
T1 - Pregnancy Intentions Among Women Living With HIV in the United States
AU - Rahangdale, Lisa
AU - Stewart, Amanda
AU - Stewart, Robert D.
AU - Badell, Martina
AU - Levison, Judy
AU - Ellis, Pamala
AU - Cohn, Susan E.
AU - Kempf, Mirjam Colette
AU - Lazenby, Gweneth B.
AU - Tandon, Richa
AU - Rana, Aadia
AU - Nguyen, Minh Ly
AU - Sturdevant, Marcia S.
AU - Cohan, Deborah
PY - 2014/3/1
Y1 - 2014/3/1
N2 - BACKGROUND:: The number of HIV-infected women giving birth in the United States is increasing. Research on pregnancy planning in HIV-infected women is limited. METHODS:: Between January 1 and December 30, 2012, pregnant women with a known HIV diagnosis before conception at 12 US urban medical centers completed a survey including the London Measure of Unplanned Pregnancy (LMUP) scale. We assessed predictors of LMUP category (unplanned/ambivalent versus planned pregnancy) using bivariate and multivariable analyses. RESULTS:: Overall, 172 women met inclusion criteria and completed a survey. Based on self-report using the LMUP scale, 23% women had an unplanned pregnancy, 58% were ambivalent, and 19% reported a planned pregnancy. Women were at lower risk for an unplanned or ambivalent pregnancy if they had previously given birth since their HIV diagnosis [adjusted relative risk (aRR) = 0.67, 95% confidence interval (CI): 0.47 to 0.94, P = 0.02], had seen a medical provider in the year before the index pregnancy (aRR = 0.60, 95% CI: 0.46 to 0.77, P < 0.01), or had a patient-initiated discussion of pregnancy intentions in the year before the index pregnancy (aRR = 0.63, 95% CI: 0.46 to 0.77, P < 0.01). Unplanned or ambivalent pregnancy was not associated with age, race/ethnicity, or educational level. CONCLUSIONS:: In this multisite US cohort, patient-initiated pregnancy counseling and being engaged in medical care before pregnancy were associated with a decreased probability of unplanned or ambivalent pregnancy. Interventions that promote healthcare engagement among HIV-infected women and integrate contraception and preconception counseling into routine HIV care may decrease the risk of unplanned pregnancy among HIV-infected women in the United States.
AB - BACKGROUND:: The number of HIV-infected women giving birth in the United States is increasing. Research on pregnancy planning in HIV-infected women is limited. METHODS:: Between January 1 and December 30, 2012, pregnant women with a known HIV diagnosis before conception at 12 US urban medical centers completed a survey including the London Measure of Unplanned Pregnancy (LMUP) scale. We assessed predictors of LMUP category (unplanned/ambivalent versus planned pregnancy) using bivariate and multivariable analyses. RESULTS:: Overall, 172 women met inclusion criteria and completed a survey. Based on self-report using the LMUP scale, 23% women had an unplanned pregnancy, 58% were ambivalent, and 19% reported a planned pregnancy. Women were at lower risk for an unplanned or ambivalent pregnancy if they had previously given birth since their HIV diagnosis [adjusted relative risk (aRR) = 0.67, 95% confidence interval (CI): 0.47 to 0.94, P = 0.02], had seen a medical provider in the year before the index pregnancy (aRR = 0.60, 95% CI: 0.46 to 0.77, P < 0.01), or had a patient-initiated discussion of pregnancy intentions in the year before the index pregnancy (aRR = 0.63, 95% CI: 0.46 to 0.77, P < 0.01). Unplanned or ambivalent pregnancy was not associated with age, race/ethnicity, or educational level. CONCLUSIONS:: In this multisite US cohort, patient-initiated pregnancy counseling and being engaged in medical care before pregnancy were associated with a decreased probability of unplanned or ambivalent pregnancy. Interventions that promote healthcare engagement among HIV-infected women and integrate contraception and preconception counseling into routine HIV care may decrease the risk of unplanned pregnancy among HIV-infected women in the United States.
KW - HIV
KW - pregnancy
KW - pregnancy intention
KW - serodifferent
KW - serodiscordant
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U2 - 10.1097/QAI.0000000000000014
DO - 10.1097/QAI.0000000000000014
M3 - Article
C2 - 24525467
AN - SCOPUS:84894487324
SN - 1525-4135
VL - 65
SP - 306
EP - 311
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -