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Antiretroviral Therapy is Associated with Increased Fertility Desire, but not Pregnancy or Live Birth, among HIV+ Women in an Early HIV Treatment Program in Rural Uganda

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Abstract

To assess the association between antiretroviral therapy (ART) and fertility history and desire among HIV-positive Ugandan women, we conducted a cross-sectional study among HIV-positive Ugandan women aged 18–50 years who attended an HIV clinic at Mbarara University in western Uganda between November 1, 2005 and June 6, 2006. Of 538 women approached, 501 were enrolled. ART use was associated with increased odds of fertility desire (AOR 2.99, 95% CI 1.38–6.28), and decreased odds of pregnancy (AOR 0.56, 95% CI 0.33–0.95) and live birth (AOR 0.30, 95% CI 0.13–0.66). ART was associated with an increase in fertility desire, but was not associated with an increase in fertility. Additional studies will be needed to determine if this greater fertility desire among ART-treated women leads to an increase in fertility as ART use expands.

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Acknowledgements

Funding was provided from The Doris Duke Charitable Foundation, NIMH 54907, and NIAAA K-24 015287. The authors thank the Mbarara Hospital ISS clinic and Mbarara Hospital for their administrative support, as well as Drs. Deborah Cohan and John Tercier for their critical review of the manuscript. Finally, the authors thank the study participants for their time and willingness to share personal information with the study team.

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Authors and Affiliations

  1. Department of Internal Medicine, Oregon Health & Science University, Mail Code OP-30, 3181 S.W. Sam Jackson Park Road, Portland, OR, 97239-3098, USA

    Marissa Maier

  2. Department of Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Nneka Emenyonu, David Guzman & David R. Bangsberg

  3. Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda

    Irene Andia & Larry Pepper

  4. Department of Healthcare and Epidemiology, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada

    Angela Kaida

  5. BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada

    Angela Kaida & Robert Hogg

  6. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Robert Hogg

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  1. Marissa Maier
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  2. Irene Andia
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  3. Nneka Emenyonu
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  4. David Guzman
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  5. Angela Kaida
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  6. Larry Pepper
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  7. Robert Hogg
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  8. David R. Bangsberg
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Correspondence to Marissa Maier.

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Maier, M., Andia, I., Emenyonu, N. et al. Antiretroviral Therapy is Associated with Increased Fertility Desire, but not Pregnancy or Live Birth, among HIV+ Women in an Early HIV Treatment Program in Rural Uganda. AIDS Behav 13 (Suppl 1), 28–37 (2009). https://doi.org/10.1007/s10461-008-9371-7

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  • DOI: https://doi.org/10.1007/s10461-008-9371-7

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