Repeated pregnancy among women with known HIV status in Pune, India

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Repeated pregnancy among women with known HIV status in Pune, India

Suryavanshi, Nishi1; Erande, Ashwini1; Pisal, Hemlata1; Shankar,

Anita2; Bhosale, Ramesh3; Bollinger, 2; Phadke, Mrudula4;

Sastry, Jayagowri1

Source: AIDS Care, Volume 20, Number 9, October 2008 , pp. 1111-1118

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Abstract:

HIV-positive women of reproductive age face challenges in decision

making related to pregnancy. Understanding factors influencing repeat

pregnancies in women with known HIV status are necessary to guide

interventions and counseling strategies to better inform and support

them.

We compared three groups of women attending a large antenatal clinic

in Pune, India. They include: Group A - 63 HIV-positive women

comingfor care for a repeat pregnancy after being diagnosed in a

previous pregnancy; Group B - 64 HIV-negative (repeat) pregnant women

attendingthis antenatal clinic; and Group C - 63 HIV-positive non-

pregnant women currently enrolled in an ongoing clinical trial.

Comparisons of Group A and B indicate that the likelihood of

unplanned repeat pregnancies was significantly higher in HIV-positive

(70%) than HIV-negative (36%) women (OR=4.1, CI: 2.0-8.7). Inability

to terminate the pregnancy (31%) and familial obligations (40%)

appear to be important for continuing the unplanned repeat pregnancy.

Despite high reported contraceptive use by HIV-positive women,

pregnancies still occurred. Death of their youngest child is an

important factor as 21% of HIV-positive pregnant women lost their

youngest child compared with 3% of HIV-negative women and 3% of HIV-

positive non-pregnant women (p<0.001).

Repeat pregnancies were more likely to occur for women who did not

disclose their HIV status to their spouse. Thus the majority of the

repeat pregnancies for HIV-positive women were both unplanned and

unwanted.

Keywords: HIV; contraception; pregnancy; decision making; India

Document Type: Research article

DOI: 10.1080/09540120701842753

Affiliations: 1: Byramjee Jeejeebhoy Medical College-MIT Study, Pune,

India 2: s Hopkins University, Baltimore, United States 3:

Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Medical

College, Pune, India 4: Maharashtra University of Health Sciences,

Nasik, India