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Female HIV-1 Risk in Pregnancy and Postpartum

J Infect Dis; ePub 2018 Mar 5; Thomson, et al

During late pregnancy and postpartum, the risk of female HIV-1 acquisition per condomless sex steadily increases, and is highest during the postpartum period, a recent study suggests. Researchers used data from 2,751 HIV-1 serodiscordant couples to compare the probability of women’s HIV-1 acquisition risk per sex act during pregnancy, late pregnancy, postpartum, and non-pregnant periods. They found:

  • 686 pregnancies were identified and 82 incident HIV-1 infections occurred.
  • After adjustment for condom use, age, pre-exposure prophylaxis (PrEP) use, and HIV-1 viral load, the per act probability of HIV-1 acquisition was 3- and 4-fold higher in late pregnancy and postpartum vs nonpregnant periods.
  • For a woman aged 25 not taking PrEP with an HIV-infected male partner with viral load of 10,000 copies/ml, the HIV-1 acquisition probability per condomless sex act was 0.0011, 0.0022, 0.0030, and 0.0042 in the nonpregnant, early pregnant, late pregnant, and postpartum periods, respectively.

Citation:

Thomson KA, Hughes J, Baeten JM, et al. Increased risk of female HIV-1 acquisition throughout pregnancy and postpartum: A prospective per-coital act analysis among women with HIV-1 infected partners. [Published online ahead of print March 5, 2018]. J Infect Dis. doi:10.1093/infdis/jiy113.

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