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Prevention of mother-to-child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000-10.
- Source :
-
Addiction . Jan2012, Vol. 107 Issue 1, p118-128. 11p. 4 Charts, 1 Graph. - Publication Year :
- 2012
-
Abstract
- ABSTRACT Aims To compare clinical status, mother-to-child transmission (MTCT) rates, use of prevention of (PMTCT) interventions and pregnancy outcomes between HIV-infected injecting drug users (IDUs) and non-IDUs. Design and setting Prospective cohort study conducted in seven human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Centres in Ukraine, 2000-10. Participants Pregnant HIV-infected women, identified before/during pregnancy or intrapartum, and their live-born infants ( n = 6200); 1028 women followed post-partum. Measurements Maternal and delivery characteristics, PMTCT prophylaxis, MTCT rates, preterm delivery (PTD) and low birth weight (LBW). Findings Of 6200 women, 1111 (18%) reported current/previous IDU. The proportion of IDUs diagnosed with HIV before conception increased from 31% in 2000/01 to 60% in 2008/09 ( P < 0.01). Among women with undiagnosed HIV at conception, 20% of IDUs were diagnosed intrapartum versus 4% of non-IDUs ( P < 0.01). At enrolment, 14% of IDUs had severe/advanced HIV symptoms versus 6% of non-IDUs ( P < 0.001). IDUs had higher rates of PTD and LBW infants than non-IDUs, respectively, 16% versus 7% and 22% versus 10% ( P < 0.001). IDUs were more likely to receive no neonatal or intrapartum PMTCT prophylaxis compared with non-IDUs (OR 2.81, p < 0.001). MTCT rates were 10.8% in IDUs versus 5.9% in non-IDUs; IDUs had increased MTCT risk (adjusted odds ratio 1.32, P = 0.049). Fewer IDUs with treatment indications received HAART compared with non-IDUs (58% versus 68%, P = 0.03). Conclusions Pregnant human immunodeficiency virus-infected injecting drug users in Ukraine have worse clinical status, poorer access to prevention of mother-to-child transmission prophylaxis and highly active antiretroviral therapy, more adverse pregnancy outcomes and higher risk of mother-to-child transmission than non-injecting drug user women. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HIV infection transmission
*ANTIRETROVIRAL agents
*ANALYSIS of variance
*CHI-squared test
*CONFIDENCE intervals
*EPIDEMIOLOGY
*HEALTH services accessibility
*HEALTH status indicators
*HIV infections
*LONGITUDINAL method
*EVALUATION of medical care
*SCIENTIFIC observation
*PREGNANCY
*PREGNANT women
*QUESTIONNAIRES
*RESEARCH funding
*SELF-evaluation
*STATISTICS
*LOGISTIC regression analysis
*DATA analysis
*INTRAVENOUS drug abusers
*DATA analysis software
*VERTICAL transmission (Communicable diseases)
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 09652140
- Volume :
- 107
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Addiction
- Publication Type :
- Academic Journal
- Accession number :
- 69605109
- Full Text :
- https://doi.org/10.1111/j.1360-0443.2011.03609.x