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dc.contributor.authorKaida, A
dc.contributor.authorKabakyenga, J
dc.contributor.authorBwana, M
dc.contributor.authorBajunirwe, F
dc.contributor.authorMayindike, W
dc.contributor.authorBennett, K
dc.contributor.authorKembabazi, A
dc.contributor.authorHaberer, JE
dc.contributor.authorBoum, Y
dc.contributor.authorMartin, JN
dc.contributor.authorHunt, PW
dc.contributor.authorBangsberg, DR
dc.contributor.authorMatthews, LT
dc.date.accessioned2019-04-24T02:36:36Z
dc.date.available2019-04-24T02:36:36Z
dc.date.issued2019-04-15
dc.date.submitted2019-04-23
dc.identifier.issn1944-7884
dc.identifier.pmid30973545
dc.identifier.doi10.1097/QAI.0000000000002053
dc.identifier.urihttp://hdl.handle.net/10144/619375
dc.description.abstractMany men with HIV express fertility intentions and nearly half have HIV-uninfected sexual partners. We measured partner pregnancy among a cohort of men accessing antiretroviral therapy (ART) in Uganda. Self-reported partner pregnancy incidence and bloodwork (CD4, HIV-RNA) were collected quarterly. Interviewer-administered questionnaires assessed men's sexual and reproductive health annually and repeated at time of reported pregnancy (2011-2015). We measured partner pregnancy incidence overall, by pregnancy intention, and by reported partner HIV-serostatus. We assessed viral suppression (≤400 copies/mL) during the peri-conception period. Cox proportional hazard regression with repeated events identified predictors of partner pregnancy. Among 189 men, baseline median age was 39.9 years [IQR:34.7,47.0], years on ART was 3.9 [IQR:0.0,5.1], and 51% were virally suppressed. Over 530.2 person-years of follow-up, 63 men reported 85 partner pregnancies (incidence=16.0/100 person-years); 45% with HIV-serodifferent partners. By three years of follow-up, 30% of men reported a partner pregnancy, with no difference by partner HIV-serostatus (p=0.75). 69% of pregnancies were intended, 18% wanted but mis-timed, and 8% unwanted. 78% of men were virally suppressed prior to pregnancy report. Men who were younger (aHR:0.94/year;95%CI:0.89-0.99), had incomplete primary education (aHR:2.95;95%CI:1.36-6.40), and reported fertility desires (aHR:2.25;95%CI:1.04-4.85) had higher probability of partner pregnancy. A high incidence of intended partner pregnancy highlights the need to address men's reproductive goals within HIV care. Nearly half of pregnancy partners were at-risk for HIV and one-quarter of men were not virally suppressed during peri-conception. Safer conception care provides opportunity to support men's health and reproductive goals, while preventing HIV transmission to women and infants.en_US
dc.language.isoenen_US
dc.publisherLippincott Williams and Wilkinsen_US
dc.rightsWith thanks to Lippincott Williams and Wilkinsen_US
dc.titleHigh incidence of intended partner pregnancy among men living with HIV in rural Uganda: Implications for safer conception services.en_US
dc.identifier.journalJournal of Acquired Immune Deficiency Syndromeen_US
dc.source.journaltitleJournal of acquired immune deficiency syndromes (1999)
refterms.dateFOA2019-04-24T02:36:37Z


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