233662 Incidence and relative time to pregnancy among HIV-infected and uninfected women in the Women's Interagency HIV Study, 2002-2009

Tuesday, November 9, 2010 : 9:10 AM - 9:30 AM

Beth S. Linas, MHS , Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Howard Minkoff, MD , Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY
Mardge H. Cohen, MD , Departments of Medicine, Stroger Hospital and Rush, Chicago, IL
Roksana Karim, PhD , Center for Health Professions, University of Southern California, Los Angeles, CA
Deborah Cohan, MD, MPH , Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Rodney Wright, MD, MS , Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY
Mary Young, MD , Georgetown University Medical Center, Washington, DC, DC
D. Heather Watts , Pama/Crmc/NICHD, Eunice Kennedy Shriver National Institute of Child Health, Bethesda, MD
Elizabeth T. Golub, PhD, MPH , Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
     
Background: For HIV-infected women in the U.S. who are considering pregnancy, HAART has provided the ability to remain healthy, survive longer and bear children. There is a paucity of literature regarding the association between HIV and conception. We examined the incidence of pregnancy and relative time to conception among HIV infected and uninfected women enrolled in the Women's Interagency HIV Study (WIHS), between 2002 and 2009. Methods: The WIHS is the largest ongoing prospective cohort study of HIV infection and related outcomes among U.S. women. Eligible subjects were age ≤45; were sexually active or reported a pregnancy outcome within the past year; and never reported hysterectomy, tubal ligation, or oopherectomy. Poisson regression was conducted to compare pregnancy incidence rates over time by HIV status. Relative time to pregnancy was ascertained via Kaplan-Meïer plots and generalized gamma survival analysis. Results: Adjusting for age, number of male sex partners, contraception, parity, exchanging sex, and alcohol use, HIV infection was associated with a 40% reduction in the incidence rate of pregnancy (incidence rate ratio=0.60, 95% confidence interval: [C.I.] 0.46-0.78). The time for HIV-infected women to become pregnant was 73% longer relative to HIV uninfected women (relative time=1.73, 95% C.I.: 1.35-2.36). In addition to HIV infection, parity and age were independent predictors of conception. Discussion: HIV-infected women had lower incidence, and slower times to pregnancy, than uninfected women. Knowledge concerning the impact of HIV infection on waiting times to conception and incidence rates of pregnancy could aide HIV-infected women who are considering family planning.

Learning Areas:
Epidemiology

Learning Objectives:
Compare the incidence rate of pregnancy by HIV status in US women between 2002 and 2009. Compare the relative to pregnancy by HIV status in US women between 2002 and 2009

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This data was analyzed as part of my Master's thesis and was completed in May 2010. It analyzes data from a cohort comprised of women who are predominately african American and at high risk for HIV infection and STDs. I am qualified to present because I have been researching data in this cohort as a student and now an employee, ie research assistant
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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