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Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study

HIV acquisition is significantly higher during pregnancy than in the postpartum period. We did a prospective study to estimate HIV incidence rates during pregnancy and lactation. We assessed 2188 HIV-negative sexually active women with 2625 exposure intervals during pregnancy and 2887 intervals duri... Full description

Journal Title: The Lancet (British edition) 2005, Vol.366 (9492), p.1182-1188
Main Author: Gray, Ronald H
Other Authors: Li, Xianbin , Kigozi, Godfrey , Serwadda, David , Brahmbhatt, Heena , Wabwire-Mangen, Fred , Nalugoda, Fred , Kiddugavu, Mohamed , Sewankambo, Nelson , Quinn, Thomas C , Reynolds, Steven J , Wawer, Maria J
Format: Electronic Article Electronic Article
Language: English
Subjects:
HIV
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/16198767
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title: Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study
format: Article
creator:
  • Gray, Ronald H
  • Li, Xianbin
  • Kigozi, Godfrey
  • Serwadda, David
  • Brahmbhatt, Heena
  • Wabwire-Mangen, Fred
  • Nalugoda, Fred
  • Kiddugavu, Mohamed
  • Sewankambo, Nelson
  • Quinn, Thomas C
  • Reynolds, Steven J
  • Wawer, Maria J
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • Breast Feeding
  • Development and progression
  • Disease transmission
  • Female
  • Health aspects
  • HIV
  • HIV infection
  • HIV infection in pregnancy
  • HIV Infections - epidemiology
  • HIV Infections - transmission
  • HIV Seropositivity
  • Human immunodeficiency virus
  • Humans
  • Incidence
  • Lactation
  • Male
  • Marital Status
  • Physiological aspects
  • Pregnancy
  • Pregnancy Complications, Infectious - epidemiology
  • Pregnant women
  • Risk Factors
  • Sexual Behavior
  • Uganda - epidemiology
ispartof: The Lancet (British edition), 2005, Vol.366 (9492), p.1182-1188
description: HIV acquisition is significantly higher during pregnancy than in the postpartum period. We did a prospective study to estimate HIV incidence rates during pregnancy and lactation. We assessed 2188 HIV-negative sexually active women with 2625 exposure intervals during pregnancy and 2887 intervals during breastfeeding, and 8473 non-pregnant and non-lactating women with 24 258 exposure intervals. Outcomes were HIV incidence rates per 100 person years and incidence rate ratios estimated by Poisson multivariate regression, with the non-pregnant or non-lactating women as the reference group. We also assessed the husbands of the married women to study male risk behaviours. HIV incidence rates were 2·3 per 100 person years during pregnancy, 1·3 per 100 person years during breastfeeding, and 1·1 per 100 person years in the non-pregnant and non-lactating women. The adjusted incidence rate ratios were 2·16 (95% CI 1·39–3·37) during pregnancy and 1·16 (0·82–1·63) during breastfeeding. Pregnant women and their male partners reported significantly fewer external sexual partners than did the other groups. In married pregnant women who had a sexual relationship with their male spouses, the HIV incidence rate ratio was 1·36 (0·63–2·93). In married pregnant women in HIV-discordant relationships (ie, with HIV-positive men) the incidence rate ratio was 1·76 (0·62–4·03). The risk of HIV acquisition rises during pregnancy. This change is unlikely to be due to sexual risk behaviours, but might be attributable to hormonal changes affecting the genital tract mucosa or immune responses. HIV prevention efforts are needed during pregnancy to protect mothers and their infants.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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creatorGray, Ronald H ; Li, Xianbin ; Kigozi, Godfrey ; Serwadda, David ; Brahmbhatt, Heena ; Wabwire-Mangen, Fred ; Nalugoda, Fred ; Kiddugavu, Mohamed ; Sewankambo, Nelson ; Quinn, Thomas C ; Reynolds, Steven J ; Wawer, Maria J
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descriptionHIV acquisition is significantly higher during pregnancy than in the postpartum period. We did a prospective study to estimate HIV incidence rates during pregnancy and lactation. We assessed 2188 HIV-negative sexually active women with 2625 exposure intervals during pregnancy and 2887 intervals during breastfeeding, and 8473 non-pregnant and non-lactating women with 24 258 exposure intervals. Outcomes were HIV incidence rates per 100 person years and incidence rate ratios estimated by Poisson multivariate regression, with the non-pregnant or non-lactating women as the reference group. We also assessed the husbands of the married women to study male risk behaviours. HIV incidence rates were 2·3 per 100 person years during pregnancy, 1·3 per 100 person years during breastfeeding, and 1·1 per 100 person years in the non-pregnant and non-lactating women. The adjusted incidence rate ratios were 2·16 (95% CI 1·39–3·37) during pregnancy and 1·16 (0·82–1·63) during breastfeeding. Pregnant women and their male partners reported significantly fewer external sexual partners than did the other groups. In married pregnant women who had a sexual relationship with their male spouses, the HIV incidence rate ratio was 1·36 (0·63–2·93). In married pregnant women in HIV-discordant relationships (ie, with HIV-positive men) the incidence rate ratio was 1·76 (0·62–4·03). The risk of HIV acquisition rises during pregnancy. This change is unlikely to be due to sexual risk behaviours, but might be attributable to hormonal changes affecting the genital tract mucosa or immune responses. HIV prevention efforts are needed during pregnancy to protect mothers and their infants.
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subjectAbridged Index Medicus ; Adolescent ; Adult ; Breast Feeding ; Development and progression ; Disease transmission ; Female ; Health aspects ; HIV ; HIV infection ; HIV infection in pregnancy ; HIV Infections - epidemiology ; HIV Infections - transmission ; HIV Seropositivity ; Human immunodeficiency virus ; Humans ; Incidence ; Lactation ; Male ; Marital Status ; Physiological aspects ; Pregnancy ; Pregnancy Complications, Infectious - epidemiology ; Pregnant women ; Risk Factors ; Sexual Behavior ; Uganda - epidemiology
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descriptionHIV acquisition is significantly higher during pregnancy than in the postpartum period. We did a prospective study to estimate HIV incidence rates during pregnancy and lactation. We assessed 2188 HIV-negative sexually active women with 2625 exposure intervals during pregnancy and 2887 intervals during breastfeeding, and 8473 non-pregnant and non-lactating women with 24 258 exposure intervals. Outcomes were HIV incidence rates per 100 person years and incidence rate ratios estimated by Poisson multivariate regression, with the non-pregnant or non-lactating women as the reference group. We also assessed the husbands of the married women to study male risk behaviours. HIV incidence rates were 2·3 per 100 person years during pregnancy, 1·3 per 100 person years during breastfeeding, and 1·1 per 100 person years in the non-pregnant and non-lactating women. The adjusted incidence rate ratios were 2·16 (95% CI 1·39–3·37) during pregnancy and 1·16 (0·82–1·63) during breastfeeding. Pregnant women and their male partners reported significantly fewer external sexual partners than did the other groups. In married pregnant women who had a sexual relationship with their male spouses, the HIV incidence rate ratio was 1·36 (0·63–2·93). In married pregnant women in HIV-discordant relationships (ie, with HIV-positive men) the incidence rate ratio was 1·76 (0·62–4·03). The risk of HIV acquisition rises during pregnancy. This change is unlikely to be due to sexual risk behaviours, but might be attributable to hormonal changes affecting the genital tract mucosa or immune responses. HIV prevention efforts are needed during pregnancy to protect mothers and their infants.
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titleIncreased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study
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abstractHIV acquisition is significantly higher during pregnancy than in the postpartum period. We did a prospective study to estimate HIV incidence rates during pregnancy and lactation. We assessed 2188 HIV-negative sexually active women with 2625 exposure intervals during pregnancy and 2887 intervals during breastfeeding, and 8473 non-pregnant and non-lactating women with 24 258 exposure intervals. Outcomes were HIV incidence rates per 100 person years and incidence rate ratios estimated by Poisson multivariate regression, with the non-pregnant or non-lactating women as the reference group. We also assessed the husbands of the married women to study male risk behaviours. HIV incidence rates were 2·3 per 100 person years during pregnancy, 1·3 per 100 person years during breastfeeding, and 1·1 per 100 person years in the non-pregnant and non-lactating women. The adjusted incidence rate ratios were 2·16 (95% CI 1·39–3·37) during pregnancy and 1·16 (0·82–1·63) during breastfeeding. Pregnant women and their male partners reported significantly fewer external sexual partners than did the other groups. In married pregnant women who had a sexual relationship with their male spouses, the HIV incidence rate ratio was 1·36 (0·63–2·93). In married pregnant women in HIV-discordant relationships (ie, with HIV-positive men) the incidence rate ratio was 1·76 (0·62–4·03). The risk of HIV acquisition rises during pregnancy. This change is unlikely to be due to sexual risk behaviours, but might be attributable to hormonal changes affecting the genital tract mucosa or immune responses. HIV prevention efforts are needed during pregnancy to protect mothers and their infants.
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