HIV and pregnancy
Researchers looked at pregnancy rates in women receiving care at 13 large clinics between 2000 and 2009.
Becoming pregnant and having an HIV-negative baby is now a realistic option for many HIV-positive women in the UK. With the right treatment and care, the risk of mother-to-child transmission of HIV can be reduced to below 1%. The effectiveness of modern HIV treatment also means that an HIV-positive mother can expect to live a long and healthy life.
To help plan services and care, it’s important to have a clear understanding of pregnancy rates in HIV-positive women.
The researchers found that over 7800 women were seen at the 13 clinics, and the number of women receiving care doubled over the course of the study.
There were a total of 1637 pregnancies in 1291 women. The number of pregnancies increased threefold between 2000-1 and 2008-9.
By the end of the study period, 58% of pregnancies involved women aged over 36. This was an important finding as pregnancy in older women, particularly those over 40, can require more specialist care.
A CD4 cell count above 350 was associated with pregnancy, and the proportion of women who were taking HIV treatment increased.
The vast majority of pregnancies resulted in live births and the number of terminations fell significantly. The fall in the number of women choosing terminations was probably because of reductions in the risk of mother-to-child transmission. Improved life expectancy was also likely to have been a factor.
“HIV-positive women with or planning a pregnancy require a high level of clinical care and this is likely to continue particularly as more older women have pregnancies,” conclude the researchers.
For more information on conception and pregnancy for women living with HIV, you can read or download our HIV & women booklet on our website.
HIV and bone health
US researchers have found evidence of reduced bone density among young men taking HIV treatment.
There’s a lot of concern about bone health in people with HIV. Infection with HIV can reduce bone density, as can HIV treatment. The problem has been especially associated with a class of anti-HIV drugs called protease inhibitors and with tenofovir (Viread, also in the combination pills Truvada, Atripla and Eviplera), which is an anti-HIV drug from the NRTI (nucleoside reverse transcriptase inhibitor) class.
Reduced bone density is a potentially serious problem as it can increase the risk of fractures. However, effective treatments are available.
Earlier research has found evidence of reduced bone density in young people who were infected with HIV at birth and in HIV-positive adults.
Researchers wanted to see if HIV and/or HIV treatment had an impact on bone density in young men aged 14 to 25. These are crucial years in bone formation.
The study included 199 men with HIV and a control group of 53 age-matched HIV-negative people.
The men with HIV were divided into groups according to their treatment history: no history of treatment; treatment based on a protease inhibitor; and treatment based on an NNRTI (a non-nucleoside reverse transcriptase inhibitor).
Overall, the men with HIV had lower bone density compared to the HIV-negative men.
But the problem mainly affected the men who were taking HIV therapy – there was little evidence of reduced bone density in the HIV-positive people who were not yet taking treatment.
Protease inhibitors were especially associated with reduced bone density.
Although the causes of reduced bone density are not well understood, there are changes you can make which can improve bone health. Exercise, eating a healthy diet and making healthy lifestyle changes such as stopping smoking can all improve bone density.
Sexual health
Research conducted in South Africa shows the importance of regular sexual health check-ups.
It found that only 12% of women with certain sexually transmitted infections (STIs) had any symptoms.
Good sexual health is important for everyone, especially so for people with or at risk of HIV. STIs can cause unpleasant symptoms, some can cause long-term damage to health if left untreated, and they can increase the risk of passing on or acquiring HIV.
A symptom of infections such as gonorrhoea and chlamydia is a genital discharge. Its presence often acts as a prompt for people to attend a sexual health clinic for tests and treatment.
However, research involving 242 women in South Africa showed that many women who have an STI do not have symptoms.
The researchers found that 88% of women who had STIs where vaginal discharge is a known symptom did not have this symptom.
In the UK sexual health check-ups and treatment are free from NHS clinics. You can find out more about sexual health and check-ups in the booklet HIV & sex.
Editors' picks from other sources
Vaginal ring may help reduce HIV infections
from Sci Dev Net
A vaginal ring containing an antiviral drug is being tested in Africa and, if successful, could provide women with an easy-to-use alternative to vaginal microbicides to help reduce their risk of HIV infection.
Plea to end transplant ban between HIV patients
from San Francisco Chronicle
A US federal ban that forbids HIV-positive donors from giving organs to HIV-positive recipients is outdated and unnecessarily restrictive and should be repealed for the benefit of all transplant patients, says a growing clutch of health care and public health experts.
The Supreme Court's Ruling Upholding the ACA Is Especially Important for LGBT People and Those Living With HIV/AIDS
from Huffington Post
In a landmark decision last week, the US Supreme Court upheld President Barack Obama's healthcare reform law (the Affordable Care Act or ACA). The court decision upholds important protections against discrimination and helps ensure access to healthcare for millions of Americans, including lesbian, gay, bisexual, and transgender (LGBT) people and people living with HIV/AIDS.
Malawi sex workers fear HIV testing
from Nyasa Times
A sex work situation analysis report has revealed that sex workers are afraid of undergoing HIV testing for fear of the consequences of being found HIV positive.