The Risk of Contracting HIV Increases During and After Pregnancy, Research Suggests

A new research has suggested that the woman’s risk of contracting HIV during sex with a HIV infected man increases during pregnancy and is highest just after birth.

While presenting the study results at the conference on Retroviruses and Opportunistic Infections (CROI) in Boston, Massachusetts, Renee Heffron, PhD, MPH, assistant professor, University of Washington, stated that findings suggest biological changes that occur during and after pregnancy may increase a woman’s HIV risk.

“Our findings suggest that biological changes during pregnancy and postpartum may increase HIV risk,” Heffron said. “This finding has a number of important public health implications. We have tremendous opportunities in antenatal and postnatal care, to promote HIV prevention and care.”

2,751 African serodiscordant couples took part in the study. The were enrolled in two HIV prevention clinical trials; the Partners in Prevention HSV/HIV Transmission Study and the Partners PrEP Study.

For approximately 48 months, HIV uninfected female partners were observed and underwent HIV and pregnancy testing either monthly or every 3 months depending on the trial. Condom use and sex frequency were reported monthly.

The time of the study was categorized by the reproductive stage as either early pregnancy, late pregnancy, up to 6 months postpartum and non-pregnant. The researchers then compared the probability of male-to-female HIV transmission per sex act by the pre-determined reproductive stage.

The pregnancy incidence was 12.5% during the study and of the 686 pregnancies, there were 82 HIV transmissions.

After accounting for condom use, PrEP and Viral load, it was clear that he probability of transmission per sex act was significantly higher in late pregnancy and increased even further for the first 6 months postpartum.

The probability of HIV transmissions per 1000 sex acts was 1.05 for non-pregnant women, 2.19 in the first 13 weeks of pregnancy, 2.97 in the last 14 weeks of pregnancy and 4.18 for the first six postpartum months.

Understanding the factors that affect HIV acquisition risk during and after pregnancy is critical given that the infections not only have negative consequences on the women, but they also carry the risk of perinatal HIV transmission to the fetus of newborn during breastfeeding. This will ensure that women receive the best prevention tools

HIV infections that occur during pregnancy or postpartum not only have negative consequences on women, but they also carry the risk of perinatal HIV transmission to the fetus or newborn through breastfeeding.

As much as further research is needed to better understand biological susceptibility, HIV prevention and testing in antenatal and postpartum care as recommended by the World Health Organization is warranted to prevent the sexual transmission and identify acute maternal HIV infections, Heffron explained.

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