high hiv incidence and sexual behavior change among pregnant women in lilongwe, malawi implications for the risk of hiv acquisition艾滋病毒感染率高,性行为变化在利隆圭的孕妇中,马拉维收购对艾滋病毒的风险.pdfVIP

High HIV Incidence and Sexual Behavior Change among Pregnant Women in Lilongwe, Malawi: Implications for the Risk of HIV Acquisition 1,2 1 3 1 3 Maria A. Keating , Gloria Hamela , William C. Miller , Agnes Moses , Irving F. Hoffman , Mina C. Hosseinipour1,3* 1 University of North Carolina Project, Lilongwe, Malawi, 2 Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America, 3 Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America Abstract Background: HIV incidence is higher among pregnant women than their non-pregnant counterparts in some sub-Saharan African settings. Our aims were (1) to estimate HIV incidence during pregnancy and (2) to compare sexual activity between pregnant, postpartum, and non-pregnant women. Methods: We examined a retrospective cohort of 1087 women to identify seroconverters using antenatal and labor ward HIV test results. We also conducted a cross-sectional survey, including a quantitative questionnaire (n = 200) and in-depth interviews (n = 20) among women in early pregnancy, late pregnancy, postpartum, and non-pregnancy. Outcomes included measures of sexual activity, reported spouse’s risky behavior, and beliefs about abstinence. Results: 11 of 1087 women seroconverted during pregnancy yielding a 1% seroconversion risk and an incidence rate of 4.0/ 100 person years (95% CI 2.2–7.2). The reported sexual activity of the early pregnancy and non-pregnancy groups was similar, but significantly higher than the late pregnancy and postpartum groups (p,0.001). During pregnancy, sex acts decreased as gestation increased (p = 0.001). There was no reporte