Pregnancy Intentions Among Women Living With HIV in the United States

Lisa Rahangdale, Amanda Stewart, Robert D. Stewart, Martina Badell, Judy Levison, Pamala Ellis, Susan E. Cohn, Mirjam Colette Kempf, Gweneth B. Lazenby, Richa Tandon, Aadia Rana, Minh Ly Nguyen, Marcia S. Sturdevant, Deborah Cohan

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

BACKGROUND:: The number of HIV-infected women giving birth in the United States is increasing. Research on pregnancy planning in HIV-infected women is limited. METHODS:: Between January 1 and December 30, 2012, pregnant women with a known HIV diagnosis before conception at 12 US urban medical centers completed a survey including the London Measure of Unplanned Pregnancy (LMUP) scale. We assessed predictors of LMUP category (unplanned/ambivalent versus planned pregnancy) using bivariate and multivariable analyses. RESULTS:: Overall, 172 women met inclusion criteria and completed a survey. Based on self-report using the LMUP scale, 23% women had an unplanned pregnancy, 58% were ambivalent, and 19% reported a planned pregnancy. Women were at lower risk for an unplanned or ambivalent pregnancy if they had previously given birth since their HIV diagnosis [adjusted relative risk (aRR) = 0.67, 95% confidence interval (CI): 0.47 to 0.94, P = 0.02], had seen a medical provider in the year before the index pregnancy (aRR = 0.60, 95% CI: 0.46 to 0.77, P < 0.01), or had a patient-initiated discussion of pregnancy intentions in the year before the index pregnancy (aRR = 0.63, 95% CI: 0.46 to 0.77, P < 0.01). Unplanned or ambivalent pregnancy was not associated with age, race/ethnicity, or educational level. CONCLUSIONS:: In this multisite US cohort, patient-initiated pregnancy counseling and being engaged in medical care before pregnancy were associated with a decreased probability of unplanned or ambivalent pregnancy. Interventions that promote healthcare engagement among HIV-infected women and integrate contraception and preconception counseling into routine HIV care may decrease the risk of unplanned pregnancy among HIV-infected women in the United States.

Original languageEnglish (US)
Pages (from-to)306-311
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume65
Issue number3
DOIs
StatePublished - Mar 1 2014

Fingerprint

Unplanned Pregnancy
HIV
Pregnancy
Family Planning Services
Confidence Intervals
Counseling
Parturition
Contraception
Self Report
Pregnant Women
Delivery of Health Care
Research

Keywords

  • HIV
  • pregnancy
  • pregnancy intention
  • serodifferent
  • serodiscordant

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Pregnancy Intentions Among Women Living With HIV in the United States. / Rahangdale, Lisa; Stewart, Amanda; Stewart, Robert D.; Badell, Martina; Levison, Judy; Ellis, Pamala; Cohn, Susan E.; Kempf, Mirjam Colette; Lazenby, Gweneth B.; Tandon, Richa; Rana, Aadia; Nguyen, Minh Ly; Sturdevant, Marcia S.; Cohan, Deborah.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 65, No. 3, 01.03.2014, p. 306-311.

Research output: Contribution to journalArticle

Rahangdale, L, Stewart, A, Stewart, RD, Badell, M, Levison, J, Ellis, P, Cohn, SE, Kempf, MC, Lazenby, GB, Tandon, R, Rana, A, Nguyen, ML, Sturdevant, MS & Cohan, D 2014, 'Pregnancy Intentions Among Women Living With HIV in the United States', Journal of Acquired Immune Deficiency Syndromes, vol. 65, no. 3, pp. 306-311. https://doi.org/10.1097/QAI.0000000000000014
Rahangdale, Lisa ; Stewart, Amanda ; Stewart, Robert D. ; Badell, Martina ; Levison, Judy ; Ellis, Pamala ; Cohn, Susan E. ; Kempf, Mirjam Colette ; Lazenby, Gweneth B. ; Tandon, Richa ; Rana, Aadia ; Nguyen, Minh Ly ; Sturdevant, Marcia S. ; Cohan, Deborah. / Pregnancy Intentions Among Women Living With HIV in the United States. In: Journal of Acquired Immune Deficiency Syndromes. 2014 ; Vol. 65, No. 3. pp. 306-311.
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abstract = "BACKGROUND:: The number of HIV-infected women giving birth in the United States is increasing. Research on pregnancy planning in HIV-infected women is limited. METHODS:: Between January 1 and December 30, 2012, pregnant women with a known HIV diagnosis before conception at 12 US urban medical centers completed a survey including the London Measure of Unplanned Pregnancy (LMUP) scale. We assessed predictors of LMUP category (unplanned/ambivalent versus planned pregnancy) using bivariate and multivariable analyses. RESULTS:: Overall, 172 women met inclusion criteria and completed a survey. Based on self-report using the LMUP scale, 23{\%} women had an unplanned pregnancy, 58{\%} were ambivalent, and 19{\%} reported a planned pregnancy. Women were at lower risk for an unplanned or ambivalent pregnancy if they had previously given birth since their HIV diagnosis [adjusted relative risk (aRR) = 0.67, 95{\%} confidence interval (CI): 0.47 to 0.94, P = 0.02], had seen a medical provider in the year before the index pregnancy (aRR = 0.60, 95{\%} CI: 0.46 to 0.77, P < 0.01), or had a patient-initiated discussion of pregnancy intentions in the year before the index pregnancy (aRR = 0.63, 95{\%} CI: 0.46 to 0.77, P < 0.01). Unplanned or ambivalent pregnancy was not associated with age, race/ethnicity, or educational level. CONCLUSIONS:: In this multisite US cohort, patient-initiated pregnancy counseling and being engaged in medical care before pregnancy were associated with a decreased probability of unplanned or ambivalent pregnancy. Interventions that promote healthcare engagement among HIV-infected women and integrate contraception and preconception counseling into routine HIV care may decrease the risk of unplanned pregnancy among HIV-infected women in the United States.",
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