HIV-Infected U.S. Women More Likely to Abort Pregnancy Than HIV-Uninfected Women

There's nothing like hearing the results of studies directly from those who actually conducted the research. In this interview, you'll meet one of these impressive HIV researchers and read her explanation of the study she presented at ICAAC/IDSA 2008.

I'm Dr. Susan Matcha from Kaiser Permanente. There are only few data comparing pregnancy completions in HIV-positive and HIV-negative women. What we found was that women without HIV are less likely to abort their pregnancies than women with HIV.

Susan Matcha, M.D.

Could you go through the data?

Sure. We have a retrospective cohort study with all women under care at Kaiser Mid-Atlantic.¹

How many women is that?

We had a total of 37,821 women in our cohort contributing 53,998 pregnancies. Ninety-four women were HIV positive for at least one of their pregnancies. Seventy-five women were HIV positive at the start of the observation period and 19 women became HIV infected during the observation period. There was no significant difference between the mean age of first pregnancy between the HIV-positive and HIV-negative women.

Seventy-six pregnancies in the HIV-positive women were carried to term versus 34,158 of the HIV-negative women for a P value of .8. For the women who chose to carry their pregnancies to term, there was no significant difference in the stillborn rate: two for the HIV-positive women versus 224 for the HIV-negative women for a P value of .09. There were fewer miscarriages among the HIV-positive women than the HIV-negative women for a P value of .046.

More HIV-positive women opted to voluntarily interrupt pregnancy than did the HIV-negative women, so 28 of the HIV-positive women versus 8,555 of the HIV-negative women for a P value of .02. This was surprising because only one of the HIV-positive women who opted for voluntary interruption of pregnancy learned of her HIV diagnosis in the 90 days prior to VIP [Voluntary Interruption of Pregnancy]. The remaining 27 women had known they were HIV infected for a mean of 22.1 months.

What were some of the reasons the women gave? Were they advised by anybody?

We don't know because this was a retrospective study.

In the Baltimore area or Mid-Atlantic area, do you think that there is still stigma about women having babies if they have HIV? That used to be a very big taboo.

I take care of these women. These women are my patients. My experience really is that I have lots of women who choose to carry their pregnancies to term. This was a surprising finding to me. There are surveys that are saying that there are stigmas associated with carrying pregnancies to term and I think we need to do further study.

Thank you.

This transcript has been lightly edited for clarity.

Reference

1. Bersoff-Matcha SJ, Rourke DL, Blank J. Completion of pregnancy in women with and without HIV in an HMO. In: Program and abstracts of the 48th Annual ICAAC/IDSA 46th Annual Meeting; October 25-28, 2008; Washington, D.C. Abstract H-452.