Uganda: ARVs Lead to Higher Pregnancy Rates. 25/6/10
A study has revealed that the introduction of anti-retroviral treatment (ART) has led to higher pregnancy rates in sub-Saharan Africa.
25 June 2010
Kampala — A study has revealed that the introduction of anti-retroviral treatment (ART) has led to higher pregnancy rates in sub-Saharan Africa.
Women put on ARVs have suddenly improved fertility and this brings questions of HIV transmission to partners and children as well as pregnancy in people living with HIV.
About 60% of all people living with HIV in sub-Saharan Africa are women. And the number of women - particularly of child-bearing age - receiving ARVs, is steadily rising.
Researchers from Cape Town and Columbia Universities analysed data from the Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative, a programme of HIV care and treatment programme for women, children and families covering many countries, and discovered that the rates of pregnancy after women began treatment tended to rise.
The study, published this month in the online journal PLoS Medicine, explains that women receiving ART may feel more motivated to have children as their health and quality of life improve.
Over a four-year period, nearly a third of the women starting ART experienced a pregnancy: 244 pregnancies occurred among women not receiving ART compared to 345 pregnancies among the women receiving ART.
The chance of pregnancy increased over time in the on-ART group to almost 80%, greater than the pre-ART group, while remaining relatively low and constant in the pre-ART group.
However, the study did not examine how pregnancy desires and sexual activity of women changed while on ART, and cannot discern why ART is linked to increased pregnancy.
Nonetheless, the researchers advise that there is need for better counselling and pregnancy-related care in combination with ART: "Understanding how pregnancy rates vary in HIV-infected women receiving ART helps support the formation of responsive, effective HIV programmes.
Female HIV patients of child-bearing age, who form the majority of patients receiving ART in sub-Saharan Africa, would benefit from programmes that combine starting HIV treatment with ART with education and contraception counselling and pregnancy-related care."