Receipt and uptake of safer conception messages among a prospective cohort of HIV-positive women on antiretroviral therapy in South Africa
Methods: We use prospective data from a clinic-based cohort study in Johannesburg, South Africa. HIV-positive women aged 18-35 on antiretroviral therapy (n=831) completed a baseline survey and ≥1 follow-up visits assessing fertility intentions, pregnancy incidence and clinical characteristics; an endline survey was administered one year post-enrollment. Chi-squared statistics compared receipt of safer conception messages by pregnancy status and fertility intentions, as well risk reduction indicators by partner serostatus.
Results: Over one-third of the cohort had a pregnancy or was trying to conceive at endline (n=291). About half of participants either trying to conceive or who had conceived during follow-up had never received safer conception advice, regardless of fertility intentions (p=0.600). Only 13.5% of those trying and 3.6% of those not trying received information about timed unprotected intercourse (p=0.041). Among women trying to conceive (n=169), the use of timed unprotected intercourse was low overall (17.1%) and even lower among those in a serodiscordant versus concordant partnership (8.5% vs 26.9%, p=0.010). ART adherence, viral suppression, and CD4 cell count were similar across both groups, with nearly one-quarter reporting <100% adherence and 40% having a CD4 count ≤ 350 cells/ml.
Conclusions: These findings suggest that clinic and patient-level interventions are needed to ensure that PLWH receive and employ safer conception strategies.
Learning Areas:Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Describe what safer conception messages a cohort of women living with HIV on antiretroviral treatment receive from their HIV care providers. Describe what risk reduction strategies women from this cohort use. Explain why implementation efforts are needed to improve safer conception for people living with HIV.
Keyword(s): HIV/AIDS, Reproductive Health
Qualified on the content I am responsible for because: Riley Steiner, MPH is a doctoral student at Emory University in the Department of Behavioral Sciences and Health Education. She has over five years of experiences conducting research on sexual and reproductive health, including with adolescents and people living with HIV. She has published several pieces directly related to the fertility intentions of people living with HIV.
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.