Online Program

Rising pregnancy rates among known HIV-positive women in at health centers in addis ababa, Ethiopia

Wednesday, November 6, 2013

Solomon Sisay, MD, MPH, Center for Health Services, MSH, Addis Ababa, Ethiopia
Serkalem Girma, BSC, MPH, Center for Health Services, MSH, Addis Ababa, Ethiopia
Bud Crandall, CHS, MSH, Addis ABaba, Ethiopia
Tesfaye Arega, BSC, MSC, ENHAT CS program, MSH, Addis Ababa, Ethiopia
Elke Konings, Phd, MSH, Ethiopia, Addis Ababa, Ethiopia
Legesse Alemayehu, BSC, MPH, MSH, Addis Ababa, Ethiopia
Background: At public health centers in Ethiopia, the proportion of known HIV-positive pregnant women at entry into ANC grew from 17% in 2009 to 36% in 2011. To assess the reasons for this apparent rise in pregnancy among known HIV-positive women, we reviewed pregnancy rates among HIV-positive women of reproductive age (WRA) enrolled in HIV services.

Methods: Retrospective study of 3 cohorts of WRA starting ART at 4 health centers in Addis Ababa between 2009 and 2011 to examine pregnancy rates over time; Interviews with HIV+ pregnant women regarding reasons for their pregnancy.

Results: Among 167 women who started ART in 2008/9, 4.2% had become pregnant. Of 165 who started ART in 2009/10, 9.1% had become pregnant. Of 161 enrolled on ART in 2010/11, 13.7% had become pregnant. In the first cohort, the pregnancy rate dropped from 4.2% to 4.1% after one year and 3.8% after two years on ART. In the second cohort, the rate dropped from 9.1% to 7.5% after one year on ART. The third cohort was too recent to assess pregnancy rates after one year. Among 297 WRA enrolled in HIV care, 24% had become pregnant after knowing they were HIV+. Of these, 74% were on ART; 61% were planned pregnancies.

Conclusions: Women recently enrolled on ART had higher pregnancy rates than women on ART after one year, possibly reflecting the monthly FP counseling once on ART. The data further show substantial unmet need for FP, as 39% reported an unintended pregnancy.

Learning Areas:

Provision of health care to the public
Public health or related research

Learning Objectives:
Compare rate of pregnancy among 3 years cohort of HIV positive women of reproductive age Assess the factors for the increased rates of pregnancy among HIV positive women of reproductive age group

Keyword(s): Family Planning, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical doctor and public health specialist working as clinician for the last 7 years and currently as a clinical advisor eversince last 2 years in the HIV AIDS program
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.