High incidence of intended partner pregnancy among men living with HIV in rural Uganda: Implications for safer conception services

dc.contributor.authorKaida, Angela
dc.contributor.authorKabakyenga, Jerome
dc.contributor.authorBwana, Mwebesa
dc.contributor.authorBajunirwe, Francis
dc.contributor.authorMuyindike, Winnie
dc.contributor.authorBennett, Kara
dc.contributor.authorKembabazi, Annet
dc.contributor.authorHaberer, Jessica E.
dc.contributor.authorBoum, Yap
dc.contributor.authorMartin, Jeffrey N.
dc.contributor.authorHunt, Peter W.
dc.contributor.authorBangsberg, David R.
dc.contributor.authorMatthews, Lynn T.
dc.date.accessioned2021-12-15T15:34:38Z
dc.date.available2021-12-15T15:34:38Z
dc.date.issued2019
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.identifier.citationKaida, A., Kabakyenga, J., Bwana, M., Bajunirwe, F., Muyindike, W., Bennett, K., ... & Matthews, L. T. (2019). High incidence of intended partner pregnancy among men living with HIV in rural Uganda: Implications for safer conception services. Journal of acquired immune deficiency syndromes (1999), 81(5), 497. doi: 10.1097/QAI.0000000000002053en_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/644
dc.language.isoenen_US
dc.publisherJournal of acquired immune deficiency syndromesen_US
dc.subjectHIV, men, antiretroviral therapy (ART), safer conception, pregnancy, Ugandaen_US
dc.titleHigh incidence of intended partner pregnancy among men living with HIV in rural Uganda: Implications for safer conception servicesen_US
dc.typeArticleen_US
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