BACKGROUND: Biomedical HIV prevention trials enroll sexually active women at risk of HIV and often discontinue study product during pregnancy. We assessed risk factors for pregnancy and HIV acquisition, and the effect of pregnancy on time off study drug in HIV Prevention Trials Network 039. METHODS: A total of 1358 HIV negative, herpes simplex virus type 2-seropositive women from South Africa, Zambia, and Zimbabwe were enrolled and followed for up to 18 months. RESULTS: A total of 228 pregnancies occurred; time off study drug due to pregnancy accounted for 4% of woman-years of follow-up among women. Being pregnant was not associated with increased HIV risk (hazard ratio 0.64, 95% confidence interval 0.23-1.80, P = 0.40). However, younger age was associated with increased risk for both pregnancy and HIV. There was no association between condom use as a sole contraceptive and reduced pregnancy incidence; hormonal contraception was not associated with increased HIV risk. Bacterial vaginosis at study entry was associated with increased HIV risk (hazard ratio 2.03, P = 0.02). CONCLUSIONS: Pregnancy resulted in only a small amount of woman-time off study drug. Young women are at high risk for HIV and are an appropriate population for HIV prevention trials but also have higher risk of pregnancy. Condom use was not associated with reduced incidence of pregnancy.
BACKGROUND: Biomedical HIV prevention trials enroll sexually active women at risk of HIV and often discontinue study product during pregnancy. We assessed risk factors for pregnancy and HIV acquisition, and the effect of pregnancy on time off study drug in HIV Prevention Trials Network 039. METHODS: A total of 1358 HIV negative, herpes simplex virus type 2-seropositive women from South Africa, Zambia, and Zimbabwe were enrolled and followed for up to 18 months. RESULTS: A total of 228 pregnancies occurred; time off study drug due to pregnancy accounted for 4% of woman-years of follow-up among women. Being pregnant was not associated with increased HIV risk (hazard ratio 0.64, 95% confidence interval 0.23-1.80, P = 0.40). However, younger age was associated with increased risk for both pregnancy and HIV. There was no association between condom use as a sole contraceptive and reduced pregnancy incidence; hormonal contraception was not associated with increased HIV risk. Bacterial vaginosis at study entry was associated with increased HIV risk (hazard ratio 2.03, P = 0.02). CONCLUSIONS: Pregnancy resulted in only a small amount of woman-time off study drug. Young women are at high risk for HIV and are an appropriate population for HIV prevention trials but also have higher risk of pregnancy. Condom use was not associated with reduced incidence of pregnancy.
Authors: Elizabeth G Raymond; Douglas Taylor; Willard Cates; Elizabeth E Tolley; David Borasky; Aida Cancel; Benoit Masse; Elizabeth A Bukusi; Brooke R Johnson Journal: Sex Transm Dis Date: 2007-12 Impact factor: 2.830
Authors: Ronald H Gray; Xianbin Li; Godfrey Kigozi; David Serwadda; Heena Brahmbhatt; Fred Wabwire-Mangen; Fred Nalugoda; Mohamed Kiddugavu; Nelson Sewankambo; Thomas C Quinn; Steven J Reynolds; Maria J Wawer Journal: Lancet Date: 2005-10-01 Impact factor: 79.321
Authors: S Aboud; G Msamanga; J S Read; A Mwatha; Y Q Chen; D Potter; M Valentine; U Sharma; I Hoffmann; T E Taha; R L Goldenberg; W W Fawzi Journal: Int J STD AIDS Date: 2008-12 Impact factor: 1.359
Authors: Charles S Morrison; Jing Wang; Barbara Van Der Pol; Nancy Padian; Robert A Salata; Barbra A Richardson Journal: AIDS Date: 2007-05-11 Impact factor: 4.177
Authors: Connie Celum; Anna Wald; James Hughes; Jorge Sanchez; Stewart Reid; Sinead Delany-Moretlwe; Frances Cowan; Martin Casapia; Abner Ortiz; Jonathan Fuchs; Susan Buchbinder; Beryl Koblin; Sheryl Zwerski; Scott Rose; Jing Wang; Lawrence Corey Journal: Lancet Date: 2008-06-21 Impact factor: 79.321
Authors: Jared M Baeten; Sarah Benki; Vrasha Chohan; Ludo Lavreys; R Scott McClelland; Kishorchandra Mandaliya; Jeckoniah O Ndinya-Achola; Walter Jaoko; Julie Overbaugh Journal: AIDS Date: 2007-08-20 Impact factor: 4.177
Authors: Brenna L Anderson; Mimi Ghosh; Christina Raker; John Fahey; Yan Song; Dwight J Rouse; Charles R Wira; Susan Cu-Uvin Journal: Am J Obstet Gynecol Date: 2012-04-30 Impact factor: 8.661
Authors: Brenna L Hughes; Riana Dutt; Christina Raker; Melody Barthelemy; Richard M Rossoll; Bharat Ramratnam; Charles R Wira; Susan Cu-Uvin Journal: Am J Obstet Gynecol Date: 2016-07-05 Impact factor: 8.661
Authors: Richard M Novak; Barbara Metch; Susan Buchbinder; Robinson Cabello; Yeycy Donastorg; John-Peter Figoroa; Hend Abdul-Jauwad; Hend Adbul-Jauwad; Patrice Joseph; Ellen Koenig; David Metzger; Magda Sobieszycz; Mark Tyndall; Carmen Zorilla Journal: AIDS Date: 2013-07-17 Impact factor: 4.177
Authors: Carolyne A Akello; Katherine E Bunge; Clemensia Nakabiito; Brenda G Mirembe; Mary Glenn Fowler; Anupam Mishra; Jeanne Marrazzo; Zvavahera M Chirenje; Connie Celum; Jennifer E Balkus Journal: J Womens Health (Larchmt) Date: 2017-02-17 Impact factor: 2.681