Kerry A Thomson1, James Hughes2, Jared M Baeten1,3,4, Grace John-Stewart1,3,4,5, Connie Celum1,3,4,5, Craig R Cohen6, Kenneth Ngure3,7, James Kiarie3, Nelly Mugo3,8, Renee Heffron1,3. 1. Department of Epidemiology, University of Washington, Seattle. 2. Department of Biostatistics, University of Washington, Seattle. 3. Department of Global Health, University of Washington, Seattle. 4. Department of Medicine, University of Washington, Seattle. 5. Department of Pediatrics, University of Washington, Seattle. 6. Departments of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco. 7. Department of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi. 8. Center for Clinical Research, Kenya Medical Research Institute, Nairobi.
Abstract
Background: Understanding the absolute and relative risk of human immunodeficiency virus type 1 (HIV) acquisition during pregnancy and the postpartum period can inform HIV prevention strategies for women. Methods: We used a complementary log-log model and data from 2751 HIV-serodiscordant couples to compare the probability of HIV acquisition among women per sex act during early pregnancy, late pregnancy, the postpartum period, and the nonpregnant period. Results: At total of 686 pregnancies were identified, and 82 incident HIV infections occurred. After adjustment for condom use, age, preexposure prophylaxis (PrEP) use, and HIV viral load, the per-act probability of HIV acquisition was higher in late pregnancy (adjusted relative risk [aRR], 2.82; P = .01) and the postpartum period (aRR, 3.97; P = .01) as compared to that during nonpregnant period. For a 25-year-old woman not taking PrEP, the HIV acquisition probability per condomless sex act with an HIV-infected male partner with a viral load of 10 000 copies/mL was 0.0011 (95% confidence interval [CI] 0.005-0.0019), 0.0022 (95% CI, 0.0004-0.0093), 0.0030 (95% CI, 0.0007-0.0108), and 0.0042 (95% CI, 0.0007-0.0177) during the nonpregnant period, early pregnancy, late pregnancy, and the postpartum period, respectively. Conclusion: The HIV acquisition probability per condomless sex act steadily increased during pregnancy and was highest during the postpartum period, suggesting that biological changes during pregnancy and the postpartum period increase HIV susceptibility among women.
RCT Entities:
Background: Understanding the absolute and relative risk of human immunodeficiency virus type 1 (HIV) acquisition during pregnancy and the postpartum period can inform HIV prevention strategies for women. Methods: We used a complementary log-log model and data from 2751 HIV-serodiscordant couples to compare the probability of HIV acquisition among women per sex act during early pregnancy, late pregnancy, the postpartum period, and the nonpregnant period. Results: At total of 686 pregnancies were identified, and 82 incident HIV infections occurred. After adjustment for condom use, age, preexposure prophylaxis (PrEP) use, and HIV viral load, the per-act probability of HIV acquisition was higher in late pregnancy (adjusted relative risk [aRR], 2.82; P = .01) and the postpartum period (aRR, 3.97; P = .01) as compared to that during nonpregnant period. For a 25-year-old woman not taking PrEP, the HIV acquisition probability per condomless sex act with an HIV-infected male partner with a viral load of 10 000 copies/mL was 0.0011 (95% confidence interval [CI] 0.005-0.0019), 0.0022 (95% CI, 0.0004-0.0093), 0.0030 (95% CI, 0.0007-0.0108), and 0.0042 (95% CI, 0.0007-0.0177) during the nonpregnant period, early pregnancy, late pregnancy, and the postpartum period, respectively. Conclusion: The HIV acquisition probability per condomless sex act steadily increased during pregnancy and was highest during the postpartum period, suggesting that biological changes during pregnancy and the postpartum period increase HIV susceptibility among women.
Authors: Jennifer Mark; John Kinuthia; Alison C Roxby; Daisy Krakowiak; Alfred Osoti; Barbra A Richardson; Molly Ann Gone; Victor Asila; Saloni Parikh; Carey Farquhar Journal: Sex Transm Dis Date: 2017-09 Impact factor: 2.830
Authors: John Kinuthia; Barbra A Richardson; Alison L Drake; Daniel Matemo; Jennifer A Unger; Raymond S McClelland; Grace John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2017-02-01 Impact factor: 3.731
Authors: Susana N Asin; Susan K Eszterhas; Christiane Rollenhagen; Alysha M Heimberg; Alexandra L Howell Journal: J Infect Dis Date: 2009-09-15 Impact factor: 5.226
Authors: Mary S Campbell; James I Mullins; James P Hughes; Connie Celum; Kim G Wong; Dana N Raugi; Stefanie Sorensen; Julia N Stoddard; Hong Zhao; Wenjie Deng; Erin Kahle; Dana Panteleeff; Jared M Baeten; Francine E McCutchan; Jan Albert; Thomas Leitner; Anna Wald; Lawrence Corey; Jairam R Lingappa Journal: PLoS One Date: 2011-03-02 Impact factor: 3.240
Authors: Angela Kaida; Jerome Kabakyenga; Mwebesa Bwana; Francis Bajunirwe; Winnie Muyindike; Kara Bennett; Annet Kembabazi; Jessica E Haberer; Yap Boum; Jeffrey N Martin; Peter W Hunt; David R Bangsberg; Lynn T Matthews Journal: J Acquir Immune Defic Syndr Date: 2019-08-15 Impact factor: 3.731
Authors: Karl W le Roux; Joan Christodoulou; Emily C Davis; Linnea Stansert Katzen; Elaine Dippenaar; Mark Tomlinson; Mary Jane Rotheram-Borus Journal: AIDS Care Date: 2019-10-22
Authors: Dvora L Joseph Davey; Joseph Daniels; Cindy Beard; Nyiko Mashele; Linda-Gail Bekker; Kathryn Dovel; Jabulani Ncayiyana; Thomas J Coates; Landon Myer Journal: AIDS Care Date: 2020-06-23
Authors: Jillian Pintye; Kristin M Beima-Sofie; Pamela A Makabong'O; Anne Njoroge; Susan Brown Trinidad; Renee A Heffron; Jared M Baeten; Connie Celum; Daniel Matemo; John Kinuthia; Maureen C Kelley; Grace C John-Stewart Journal: AIDS Patient Care STDS Date: 2018-07-23 Impact factor: 5.078
Authors: Bharat S Parekh; Chin-Yih Ou; Peter N Fonjungo; Mireille B Kalou; Erin Rottinghaus; Adrian Puren; Heather Alexander; Mackenzie Hurlston Cox; John N Nkengasong Journal: Clin Microbiol Rev Date: 2018-11-28 Impact factor: 26.132