Abstract
Background
Antiretroviral therapy has minimized mother-to-child transmission of HIV and given hope to HIV-positive women considering pregnancy. In Jamaica, 36% of HIV-positive pregnant women enrolled in a pediatric/perinatal HIV/AIDS program had repeat pregnancies.
Objective
To describe the epidemiology and identify factors associated with pregnancy after HIV diagnosis among HIV-positive women in Western Jamaica.
Methods
A cross-sectional study was designed among HIV-positive women 18–54 years old who either had or did not have at least one pregnancy after HIV-positive diagnosis. A questionnaire was used to collect information on sociodemographic factors and health-seeking, reproductive, and sexual risk behaviors.
Results
A total of 219 HIV-positive women participated in this study. Length of time since HIV diagnosis, CD4 count, and birth-control methods used were significant predictors of pregnancy after HIV diagnosis. Women diagnosed with HIV <5 years previously had lower odds for pregnancy after HIV diagnosis (adjusted OR 0.12, 95% CI 0.02–0.84) compared to those who had been diagnosed ≥8 years previously. Women with CD4 count <350 were over six times as likely to have a pregnancy after HIV diagnosis (adjusted OR 6.94, 95% CI 1.18–40.66). The odds for pregnancy after HIV diagnosis for a woman decreased by 93% if her children shared the same father (adjusted OR 0.07, 95% CI 0.006–0.77).
Conclusion
This study identified significant predictors of pregnancy after HIV diagnosis that indicate that integrative family-planning interventions with supportive reproductive counseling are likely to help HIV-positive women obtain early appropriate care and plan the pregnancies they desire.
Acknowledgments
We thank the women who participated in this study, as well as the staff members at the hospitals and clinics that facilitated this study. This research was funded by Minority Health International Research Training (MHIRT) grant T37-MD001448 from the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA, and the Western Regional Health Authority (WRHA), Montego Bay, Ministry of Health, Jamaica.
Disclosure
The authors report no conflicts of interest in this work.