Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

M. Floridia, G. Masuelli, E. Tamburrini, I. Cetin, G. Liuzzi, P. Martinelli, G. Guaraldi, A. Spinillo, A. Vimercati, G. Maso, C. Pinnetti, V. Frisina, S. Dalzero, M. Ravizza, F. Di Lorenzo, G. Sterrantino, M. Meli, I. Campolmi, F. Vichi, B. Del PinR. Marocco, C. Mastroianni, V. S. Mercurio, A. Maccabruni, M. Zaramella, B. Mariani, G. Nardini, C. Stentarelli, B. Beghetto, A. M.Degli Antoni, A. Molinari, M. P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, S. Coletto, F. Di Nello, C. Madia, G. Placido, P. Milini, F. Savalli, F. Sabbatini, P. Grossi, M. Roccio, A. Capone, R. Amici, F. Parazzini, S. Vella, The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy

Research output: Contribution to journalArticlepeer-review

Abstract

Young pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001-2016, 9.0% were in women <25 years, with a significant increase over time (2001-2005: 7.0%; 2006-2010: 9.1%; 2011-2016: 12.2%, P < 0.001). Younger women had a lower rate of planned pregnancy (23.2% vs. 37.7%, odds ratio (OR) 0.50, 95% confidence interval (CI) 0.36-0.69), were more frequently diagnosed with HIV in pregnancy (46.5% vs. 20.9%, OR 3.29, 95% CI 2.54-4.25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (<25 years: 56.3%; ≥25 years: 69.0%, OR 0.58, 95% CI 0.41-0.81). During pregnancy, treatment coverage was almost universal in both age groups (98.5% vs. 99.3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Original languageEnglish
Pages (from-to)2360-2365
Number of pages6
JournalEpidemiology and Infection
Volume145
Issue number11
DOIs
Publication statusPublished - Aug 1 2017

Keywords

  • Antiretroviral treatment
  • HIV diagnosis
  • HIV testing
  • pregnancy
  • women's health

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases

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