• Have Pregnancy Rates in Human Immunodeficiency Virus-Infected Women Changed in the Era of Effective Antiretroviral Therapy for Prevention of Perinatal Transmission? (Poster 700)
  Authored by J. M. Blair, D. L. Hanson, J. L. Jones, and M. S. Dworkin
  View the original abstract

As patients on HAART have come to terms with their improved health and better life expectancy, they have had to make decisions about what to do with the rest of their lives. For many couples this means decisions about child bearing. Has the improved outlook led more women to become pregnant? Are they influenced by the knowledge that the risk of transmission to their infant is now around 1%?

Blair and colleagues examined the data from the CDC's Adult Spectrum of Disease Project from 1991 to 1998 to describe the rates of pregnancy among HIV-infected women in medical care. They found a clear increase in the pregnancy rate between 1996 and 1998. The increase occurred in women of all racial and ethnic groups. The rate was not higher among women on HAART however. Because of the nature of the study, they could not determine if the pregnancies were planned, or the result of improved fertility with better health. There is no linked data on the outcome of the pregnancies.

The study confirms what we have seen in our clinical practices over the last several years. Although we have many unanswered questions about the optimal management of pregnancy in HIV-infected women, they and their partners are more frequently choosing to have children. We need to continue to improve our management so as to reduce the risk of transmission to the child to zero, protect the mother's health, and prevent transmission to a discordant partner.