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Cross-sectional study on the prevalence and predictors of pregnancy among women living in HIV discordant relationships in a rural Rakai cohort, Uganda

Nakiganda, Lydia Jacenta LU ; Agardh, Anette LU and Asamoah, Benedict Oppong LU (2018) In BMJ Open 8(4).
Abstract

Objectives: This study examines the prevalence of pregnancy in serodiscordant couples and identifies predictors associated with pregnancy in rural Rakai, Uganda. Study design A population-based cross-sectional study that used data from the Rakai Community Cohort Study (RCCS). Setting and participants: We used data from the RCCS survey round 17 (2015-2016), which included 488 women in serodiscordant relationships. This study was conducted in Rakai district, located in south-western Uganda. Primary outcomes: Pregnancy status. Statistical analysis Multivariable modified Poisson regression using stepwise selection was used to determine characteristics and behaviours associated with pregnancy status. Results: The prevalence of pregnancy was... (More)

Objectives: This study examines the prevalence of pregnancy in serodiscordant couples and identifies predictors associated with pregnancy in rural Rakai, Uganda. Study design A population-based cross-sectional study that used data from the Rakai Community Cohort Study (RCCS). Setting and participants: We used data from the RCCS survey round 17 (2015-2016), which included 488 women in serodiscordant relationships. This study was conducted in Rakai district, located in south-western Uganda. Primary outcomes: Pregnancy status. Statistical analysis Multivariable modified Poisson regression using stepwise selection was used to determine characteristics and behaviours associated with pregnancy status. Results: The prevalence of pregnancy was 12% in women among serodiscordant couples. HIV-negative women in serodiscordant couples had a slightly higher pregnancy prevalence rate (13.6%) compared with HIV-positive women in serodiscordant couples (11%). Factors significantly associated with higher prevalence of pregnancy were; younger age 15-24 years (prevalence risk ratio (PRR)=4.04; 95% CI 1.72 to 9.50), middle age 25-34 years (PRR=2.49; 95% CI 1.05 to 5.89), Christian religion (PRR=2.26; 95% CI 1.41 to 3.63) and inconsistent condom use in the last 12 months (PRR=4.38, 95% CI 1.09 to 17.53). Neither HIV status nor HIV status disclosure was significantly associated with risk of getting pregnant. Conclusion: Nearly 12% of women in serodiscordant relationships were pregnant, highlighting the need for integrated services to prevent unintended pregnancies and reduce conceptional related risks for those choosing to conceive. Association with younger age and inconsistent condom use suggests a role for early and continued couple-based conception counselling.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
discordant couples, HIV, pregnancy, Uganda
in
BMJ Open
volume
8
issue
4
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85057108297
ISSN
2044-6055
DOI
10.1136/bmjopen-2017-019818
language
English
LU publication?
yes
id
ee06f61e-ef55-4d6c-8bb0-3445982cfc9f
date added to LUP
2018-12-04 11:11:05
date last changed
2019-02-20 11:38:52
@article{ee06f61e-ef55-4d6c-8bb0-3445982cfc9f,
  abstract     = {<p>Objectives: This study examines the prevalence of pregnancy in serodiscordant couples and identifies predictors associated with pregnancy in rural Rakai, Uganda. Study design A population-based cross-sectional study that used data from the Rakai Community Cohort Study (RCCS). Setting and participants: We used data from the RCCS survey round 17 (2015-2016), which included 488 women in serodiscordant relationships. This study was conducted in Rakai district, located in south-western Uganda. Primary outcomes: Pregnancy status. Statistical analysis Multivariable modified Poisson regression using stepwise selection was used to determine characteristics and behaviours associated with pregnancy status. Results: The prevalence of pregnancy was 12% in women among serodiscordant couples. HIV-negative women in serodiscordant couples had a slightly higher pregnancy prevalence rate (13.6%) compared with HIV-positive women in serodiscordant couples (11%). Factors significantly associated with higher prevalence of pregnancy were; younger age 15-24 years (prevalence risk ratio (PRR)=4.04; 95% CI 1.72 to 9.50), middle age 25-34 years (PRR=2.49; 95% CI 1.05 to 5.89), Christian religion (PRR=2.26; 95% CI 1.41 to 3.63) and inconsistent condom use in the last 12 months (PRR=4.38, 95% CI 1.09 to 17.53). Neither HIV status nor HIV status disclosure was significantly associated with risk of getting pregnant. Conclusion: Nearly 12% of women in serodiscordant relationships were pregnant, highlighting the need for integrated services to prevent unintended pregnancies and reduce conceptional related risks for those choosing to conceive. Association with younger age and inconsistent condom use suggests a role for early and continued couple-based conception counselling.</p>},
  articleno    = {e019818},
  author       = {Nakiganda, Lydia Jacenta and Agardh, Anette and Asamoah, Benedict Oppong},
  issn         = {2044-6055},
  keyword      = {discordant couples,HIV,pregnancy,Uganda},
  language     = {eng},
  month        = {04},
  number       = {4},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Cross-sectional study on the prevalence and predictors of pregnancy among women living in HIV discordant relationships in a rural Rakai cohort, Uganda},
  url          = {http://dx.doi.org/10.1136/bmjopen-2017-019818},
  volume       = {8},
  year         = {2018},
}