Teens with HIV have a greater risk of becoming pregnant and experience a higher rate of complications during pregnancy, according to research by Johns Hopkins. The study is based on a record analysis of 181 HIV patients, ages 13 to 24, who were treated at four hospitals during a 12-year period.
“Our analysis revealed a problem. Now we need to figure out why that is and how we, as providers, can give appropriate counseling and care to these girls and women,” said lead investigator Allison Agwu, M.D., Sc.M., a pediatric infectious disease specialist at the Johns Hopkins Children’s Center.
The researchers believe the findings are disturbing for at least two reasons: First, all teen pregnancies already run a higher risk for complications. Second, the results suggest that HIV-infected teens and young women continue with unsafe sexual behaviors and unprotected sex.
Teens who acquired HIV behaviorally rather than during birth had five times more pregnancies than their HIV-negative peers and were also more likely to give birth prematurely or experience spontaneous abortions.
Among the 181 patients in the study, more than one-third (66) got pregnant, some of whom had more than one pregnancy for a total of 96 pregnancies. More HIV-infected mothers gave birth prematurely (34 percent), compared to moms in the general population (22 percent). Also, HIV-infected moms had more spontaneous abortions, 14 percent compared to 9 percent in the general population.
The pregnancy rate of behaviorally infected patients was seven times greater than the rate of those who had been infected at birth, the researchers found. Thirty-eight of the 51 behaviorally infected teens became pregnant, compared to only 28 of the 130 girls who had been infected at birth.
Furthermore, 37 percent of those with behaviorally acquired HIV had repeat pregnancies compared to only 14 percent of those who had been infected at birth. And 41 percent of teens infected at birth were more likely to terminate the pregnancy compared to 10 percent of those who contracted HIV later in life.
Although the study involved only a small number of patients, the researchers say the findings reveal interesting differences among youth with HIV, depending on how they became infected in the first place.
“Our findings suggest that teens who were infected with HIV later in life may engage in different sexual behaviors than those infected at birth. Further analysis into these differences will help us find ways to prevent unwanted pregnancies and avoid complications from planned ones,” said senior investigator Kelly Gebo, M.D., M.P.H., a Johns Hopkins infectious disease specialist.
The researchers noted that all HIV-infected patients should be educated regarding pregnancy risk, including the risk of transferring HIV to their partners as well as their babies. Therefore, doctors who treat young patients with HIV should have regular and open discussions regarding these risks, they said.
The study is published in the Feb. 2 issue of the Journal of the American Medical Association.
Source: Johns Hopkins