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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.


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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