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Pregnant women at higher risk for HIV, Uganda study finds

The risk of acquiring HIV rises during pregnancy, according to a study of women in Uganda's Rakai District led by researchers at the Johns Hopkins Bloomberg School of Public Health. The increased risk for acquiring HIV remained even after researchers controlled for behavior and other factors that contribute to HIV risk. The findings, which are published in the September 30, 2005, edition of The Lancet, suggest that the increased risk was likely due to biological changes during pregnancy.

"We cannot generalize our findings beyond the Rakai setting and it would be important for other investigators to verify our results. However, if women are at increased risk of HIV acquisition during pregnancy, our findings represent a public-health problem, both for the mother and possibly her unborn infant," said the study's lead author Ronald Gray, MD, the Robertson Professor of Reproductive Epidemiology in the Bloomberg School's Department of Population and Family Health Sciences. "We believe that it would be prudent to warn women of this potential risk of HIV acquisition during pregnancy and promote safe sex or sexual abstinence where feasible."

The study supports the findings of two previous studies that reported a greater risk of acquiring HIV during pregnancy than after delivery. However, neither study accounted for risk factors that contribute to HIV risk.

Gray and his colleagues assessed 2,188 HIV-negative women who were sexually active and were pregnant or breastfeeding, and compared their rates of HIV acquisition to 8,473 women who were neither pregnant nor lactating. They compared the incidence rates of HIV during pregnancy and breastfeeding with the rates during intervals when pregnancy and breastfeeding were absent. The sexual behaviors of husbands of married women in the study were also assessed.

According to the investigators, the rate of HIV acquisition was higher during intervals of pregnancy than during breastfeeding or during inte
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Contact: Tim Parsons
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
29-Sep-2005


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