Prevalence and determinants of unplanned pregnancy in HIV-positive and HIV-negative pregnant women in Cape Town, South Africa: a cross-sectional study.
Prevalence and determinants of unplanned pregnancy in HIV-positive and HIV-negative pregnant women in Cape Town, South Africa: a cross-sectional study.
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DOI：
10.1136/bmjopen-2017-019979
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发表时间：
2018-04-03
期刊：
影响因子：
2.9
通讯作者：
Myer L
中科院分区：
文献类型：
--
作者：
Iyun V;Brittain K;Phillips TK;le Roux S;McIntyre JA;Zerbe A;Petro G;Abrams EJ;Myer L
预防计划外怀孕是预防艾滋病毒母婴传播的一个重要方面。很少有数据调查艾滋病毒状况和抗逆转录病毒疗法（ART）的使用如何影响艾滋病毒高负担环境中的妊娠计划。我们的目的是研究南非开普敦艾滋病毒阳性和阴性妇女中计划外怀孕的流行率和决定因素。横截面分析。南非开普敦的一个初级产前保健诊所。包括2013年3月至2015年8月预订产前护理的艾滋病毒阳性和艾滋病毒阴性孕妇。计划外妊娠在首次产前检查时使用伦敦计划外妊娠测量（LMUP）进行测量。分析检查了四组参与者的LMUP评分，这些参与者由他们的艾滋病毒状态，当前妊娠前对艾滋病毒状态的认识和/或他们在当前妊娠前是否使用抗逆转录病毒治疗（ART）定义。在2 105名孕妇（1 512名艾滋病毒阳性; 593名艾滋病毒阴性）中，中位年龄为28岁，43%已婚/同居，20%未经产。艾滋病毒阳性妇女的计划外怀孕率明显高于艾滋病毒阴性妇女（50%比33%，p<0.001）;已知艾滋病毒阳性但未接受抗逆转录病毒治疗的妇女的计划外怀孕率最高（53%）。在调整年龄、产次和婚姻状况后，计划外怀孕在新诊断的妇女和已知艾滋病毒阳性但未接受抗逆转录病毒治疗的妇女中最常见（与艾滋病毒阴性妇女相比，调整后的OR（aOR）：1.43; 95%CI 1.05 - 1.94和aOR：1.57; 95%CI 1.13 - 2.15）。产次增加和年龄更小（<24岁）也与计划外妊娠相关（aOR：1.42; 95%CI 1.25 - 1.60和aOR：1.83; 95%CI 1.23 - 2.74）。我们观察到艾滋病毒阳性妇女，特别是未接受抗逆转录病毒治疗的妇女的计划外怀孕率很高，这表明艾滋病毒阳性妇女正在错过改善计划生育和咨询服务的机会。
Prevention of unplanned pregnancy is a crucial aspect of preventing mother-to-child HIV transmission. There are few data investigating how HIV status and use of antiretroviral therapy (ART) may influence pregnancy planning in high HIV burden settings. Our objective was to examine the prevalence and determinants of unplanned pregnancy among HIV-positive and HIV-negative women in Cape Town, South Africa. Cross-sectional analysis. Single primary-level antenatal care clinic in Cape Town, South Africa. HIV-positive and HIV-negative pregnant women, booking for antenatal care from March 2013 to August 2015, were included. Unplanned pregnancy was measured at the first antenatal care visit using the London Measure of Unplanned Pregnancy (LMUP). Analyses examined LMUP scores across four groups of participants defined by their HIV status, awareness of their HIV status prior to the current pregnancy and/or whether they were using antiretroviral therapy (ART) prior to the current pregnancy. Among 2105 pregnant women (1512 HIV positive; 593 HIV negative), median age was 28 years, 43% were married/cohabiting and 20% were nulliparous. Levels of unplanned pregnancy were significantly higher in HIV-positive versus HIV-negative women (50% vs 33%, p<0.001); and highest in women who were known HIV positive but not on ART (53%). After adjusting for age, parity and marital status, unplanned pregnancy was most common among women newly diagnosed and women who were known HIV positive but not on ART (compared with HIV-negative women, adjusted OR (aOR): 1.43; 95% CI 1.05 to 1.94 and aOR: 1.57; 95% CI 1.13 to 2.15, respectively). Increased parity and younger age (<24 years) were also associated with unplanned pregnancy (aOR: 1.42; 95% CI 1.25 to 1.60 and aOR: 1.83; 95% CI 1.23 to 2.74, respectively). We observed high levels of unplanned pregnancy among HIV-positive women, particularly among those not on ART, suggesting ongoing missed opportunities for improved family planning and counselling services for HIV-positive women.
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影响因子：
4.5
作者：
Mayondi GK;Wirth K;Morroni C;Moyo S;Ajibola G;Diseko M;Sakoi M;Magetse JD;Moabi K;Leidner J;Makhema J;Kammerer B;Lockman S
通讯作者：
Lockman S
影响因子：
6.3
作者：
Barrett, G;Smith, SC;Wellings, K
通讯作者：
Wellings, K
DOI：
10.7196/samj.7605
发表时间：
2014-03-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Bhardwaj, S;Barron, P;Sherman, G
通讯作者：
Sherman, G
影响因子：
2.1
作者：
Sedgh G;Singh S;Hussain R
通讯作者：
Hussain R
影响因子：
3.1
作者：
Hall J;Barrett G;Mbwana N;Copas A;Malata A;Stephenson J
通讯作者：
Stephenson J