Sexual and reproductive life of women informed of their HIV seropositivity:: A prospective cohort study in Burkina Faso
Sexual and reproductive life of women informed of their HIV seropositivity:: A prospective cohort study in Burkina Faso
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DOI：
10.1097/00126334-200112010-00010
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发表时间：
2001-12-01
期刊：
影响因子：
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通讯作者：
Dabis, F
中科院分区：
文献类型：
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作者：
Nebié, Y;Meda, N;Dabis, F
背景资料：在评估旨在减少波波-迪乌拉索（布基纳法索）母婴传播艾滋病毒的干预措施的DITRAME-ANRS 049研究方案的背景下，为孕妇建立了自愿艾滋病毒咨询和检测服务。建议感染艾滋病毒的妇女向接受自愿咨询和检测的男性伴侣透露其艾滋病毒血清状况，使用避孕套以减少性传播，并选择有效的避孕方法以避免意外怀孕。本研究旨在评估艾滋病毒检测结果如何与男性性伴侣共享，现代避孕方法的使用水平，以及这些妇女在艾滋病毒感染期间了解性和生殖健康风险的妊娠发生率。方法：从1995年至1999年，对一组艾滋病毒阳性妇女进行季度前瞻性随访。总体而言，在分娩后平均13.5个月内监测了306名艾滋病毒呈阳性的妇女，共计389人-年。队列入组时的平均年龄为25.1岁（标准差为5.2岁）。总体而言，18%的妇女通知了她们的伴侣，8%的妇女在每次性交时使用避孕套以避免艾滋病毒传播，39%的妇女开始使用激素避孕。共有48例妊娠发生在艾滋病毒感染确诊后，发生率为每100人年12.3例妊娠。妊娠发生率在监测的第一年为4/100人年，在第三年显著上升至18/100人年。艾滋病毒诊断后怀孕的唯一预测因素是前一次怀孕的不良结局（死产、婴儿死亡）。严重的免疫缺陷和婚姻状况的变化是唯一的因素，防止发生怀孕后，HIV diagnosis.Conclusion：我们的研究表明，尽管定期的建议和咨询艾滋病毒检测共享率差和避孕方法的使用差。怀孕率与一般人口的怀孕率相当。为了改善这种情况，应制定、评估和实施让丈夫或伴侣参与自愿咨询和检测以及预防母婴传播干预措施的方法。
Background: In the context of the DITRAME-ANRS 049 research program that evaluated interventions aimed at reducing mother-to-child transmission of HIV (MTCT) in Bobo-Dioulasso (Burkina Faso), Voluntary HIV counseling and testing (VCT) services were established for pregnant women. HIV-infected women were advised to disclose their HIV serostatus to their male partners who were also offered VCT, to use condoms to reduce sexual transmission, and to choose an effective contraception method to avoid unwanted pregnancies. This study aimed at assessing how HIV test results were shared with male sexual partners, the level of use of modern contraceptive methods, and the pregnancy incidence among these women informed of the risks surrounding sexual and reproductive health during HIV infection.Methods: From 1995 to 1999, a quarterly prospective follow-up of a cohort of HIV-positive women.Results: Overall, 306 HIV-positive women were monitored over an average period of 13.5 months following childbirth, accounting for a total of 389 person-years. The mean age at enrollment in the cohort was 25.1 (standard deviation, 5.2 years). In all, 18% of women informed their partners, 8% used condoms at each instance of sexual intercourse to avoid HIV transmission, and 39% started using hormonal contraception. A total of 48 pregnancies occurred after HIV infection was diagnosed, an incidence of 12.3 pregnancies per 100 person-years. Pregnancy incidence was 4 per 100 person-years in the first year of monitoring and this rose significantly to 18 per 100 person-years in the third year. The only predictor of the occurrence of a pregnancy after HIV diagnosis was the poor outcome of the previous pregnancy (stillbirth, infant death). Severe immunodeficiency and change in marital status were the only factors that prevented the occurrence of a pregnancy after HIV diagnosis.Conclusion: Our study shows a poor rate of HIV test sharing and a poor use of contraceptive methods despite regular advice and counseling. Pregnancy incidence remained comparable with the pregnancy rate in the general population. To improve this situation, approaches for involving husbands or partners in VCT and prevention of MTCT interventions should be developed, evaluated, and implemented.