The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda
The study attempted to determine the incidence of HIV among pregnant women in Kabarole District, Uganda, and to identify socio-demographic and behavioral risk factors for seroconversion during pregnancy. We carried out a retrospective cohort study among women for whom a documented HIV-negative test...
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| Veröffentlicht in: | PloS one 2020-06, Vol.15 (6), p.e0234174-e0234174 |
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| creator | Schumann, Hannah Rubagumya, Kenyonyozi Rubaihayo, John Harms, Gundel Wanyenze, Rhoda K Theuring, Stefanie |
| description | The study attempted to determine the incidence of HIV among pregnant women in Kabarole District, Uganda, and to identify socio-demographic and behavioral risk factors for seroconversion during pregnancy.
We carried out a retrospective cohort study among women for whom a documented HIV-negative test result from the first pregnancy trimester could be confirmed using available records, and who were HIV-retested in the third trimester or during delivery. In total, 1610 pregnant women from three different healthcare settings took part in the study. We captured the results of repeated HIV tests and conducted semi-structured interviews to explore participants' socio-demographic characteristics and sexual risk behavior. For HIV incidence rates, we calculated the number of seroconversions per 100 person-years. We used Fisher's exact test to test for potential associations. Penalized maximum likelihood logistic regression and Poisson regression were applied to adjust for potential confounders.
The overall HIV incidence rate among participants was 2.9/100 women-years. Among socio-demographic characteristics, the multivariable analysis showed a significant association of marital status with HIV incidence in pregnancy (IRR 8.78, 95%CI [1.13-68.33]). Risky sexual behaviors including higher number of sexual partners in pregnancy (IRR 2.78 [1.30-5.94]), unprotected sex with unknown persons (IRR 14.25 [4.52-44.93]), alcohol abuse (IRR 12.08 [4.18-34.90]) and sex under the influence of drugs or alcohol (IRR 6.33 [1.36-29.49]) were significantly associated with seroconversion in pregnancy (similar results in logistic regression).
HIV incidence was three times higher among our pregnant study population compared to the general female population in Uganda. This underlines the importance of HIV prevention and repeat testing during pregnancy. Identified risk groups should be considered for pre-exposure prophylaxis. |
| doi_str_mv | 10.1371/journal.pone.0234174 |
| format | Article |
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We carried out a retrospective cohort study among women for whom a documented HIV-negative test result from the first pregnancy trimester could be confirmed using available records, and who were HIV-retested in the third trimester or during delivery. In total, 1610 pregnant women from three different healthcare settings took part in the study. We captured the results of repeated HIV tests and conducted semi-structured interviews to explore participants' socio-demographic characteristics and sexual risk behavior. For HIV incidence rates, we calculated the number of seroconversions per 100 person-years. We used Fisher's exact test to test for potential associations. Penalized maximum likelihood logistic regression and Poisson regression were applied to adjust for potential confounders.
The overall HIV incidence rate among participants was 2.9/100 women-years. Among socio-demographic characteristics, the multivariable analysis showed a significant association of marital status with HIV incidence in pregnancy (IRR 8.78, 95%CI [1.13-68.33]). Risky sexual behaviors including higher number of sexual partners in pregnancy (IRR 2.78 [1.30-5.94]), unprotected sex with unknown persons (IRR 14.25 [4.52-44.93]), alcohol abuse (IRR 12.08 [4.18-34.90]) and sex under the influence of drugs or alcohol (IRR 6.33 [1.36-29.49]) were significantly associated with seroconversion in pregnancy (similar results in logistic regression).
HIV incidence was three times higher among our pregnant study population compared to the general female population in Uganda. This underlines the importance of HIV prevention and repeat testing during pregnancy. Identified risk groups should be considered for pre-exposure prophylaxis.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0234174</identifier><identifier>PMID: 32502227</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abuse ; Adolescent ; Adult ; Alcohol abuse ; Alcohol use ; Alcoholism ; Biology and Life Sciences ; Cohort Studies ; Data collection ; Demographic aspects ; Demographics ; Drinking (Alcoholic beverages) ; Drug abuse ; Female ; Health risks ; Health sciences ; HIV ; HIV infections ; HIV Infections - epidemiology ; HIV Infections - psychology ; HIV tests ; Hospitals ; Human immunodeficiency virus ; Humans ; Identification methods ; Incidence ; Infections ; Marriage ; Medical tests ; Medicine and Health Sciences ; People and Places ; Population studies ; Pregnancy ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - psychology ; Pregnant women ; Prevention ; Prophylaxis ; Questionnaires ; Regression analysis ; Retrospective Studies ; Risk analysis ; Risk Factors ; Risk groups ; Risk taking ; Seroconversion ; Setting (Literature) ; Sex ; Sexual Behavior ; Sexual partners ; Sexually transmitted disease prevention ; Sexually transmitted diseases ; Social Sciences ; Sociodemographics ; STD ; Studies ; Testing ; Uganda - epidemiology ; Womens health ; Young Adult</subject><ispartof>PloS one, 2020-06, Vol.15 (6), p.e0234174-e0234174</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Schumann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Schumann et al 2020 Schumann et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c8e7852737c9c9c5a00e4bf5ed23d4892b4e111651c52709ab8d1032b9826e253</citedby><cites>FETCH-LOGICAL-c692t-c8e7852737c9c9c5a00e4bf5ed23d4892b4e111651c52709ab8d1032b9826e253</cites><orcidid>0000-0002-5372-7903</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274402/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274402/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32502227$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schumann, Hannah</creatorcontrib><creatorcontrib>Rubagumya, Kenyonyozi</creatorcontrib><creatorcontrib>Rubaihayo, John</creatorcontrib><creatorcontrib>Harms, Gundel</creatorcontrib><creatorcontrib>Wanyenze, Rhoda K</creatorcontrib><creatorcontrib>Theuring, Stefanie</creatorcontrib><title>The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The study attempted to determine the incidence of HIV among pregnant women in Kabarole District, Uganda, and to identify socio-demographic and behavioral risk factors for seroconversion during pregnancy.
We carried out a retrospective cohort study among women for whom a documented HIV-negative test result from the first pregnancy trimester could be confirmed using available records, and who were HIV-retested in the third trimester or during delivery. In total, 1610 pregnant women from three different healthcare settings took part in the study. We captured the results of repeated HIV tests and conducted semi-structured interviews to explore participants' socio-demographic characteristics and sexual risk behavior. For HIV incidence rates, we calculated the number of seroconversions per 100 person-years. We used Fisher's exact test to test for potential associations. Penalized maximum likelihood logistic regression and Poisson regression were applied to adjust for potential confounders.
The overall HIV incidence rate among participants was 2.9/100 women-years. Among socio-demographic characteristics, the multivariable analysis showed a significant association of marital status with HIV incidence in pregnancy (IRR 8.78, 95%CI [1.13-68.33]). Risky sexual behaviors including higher number of sexual partners in pregnancy (IRR 2.78 [1.30-5.94]), unprotected sex with unknown persons (IRR 14.25 [4.52-44.93]), alcohol abuse (IRR 12.08 [4.18-34.90]) and sex under the influence of drugs or alcohol (IRR 6.33 [1.36-29.49]) were significantly associated with seroconversion in pregnancy (similar results in logistic regression).
HIV incidence was three times higher among our pregnant study population compared to the general female population in Uganda. This underlines the importance of HIV prevention and repeat testing during pregnancy. Identified risk groups should be considered for pre-exposure prophylaxis.</description><subject>Abuse</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Alcohol abuse</subject><subject>Alcohol use</subject><subject>Alcoholism</subject><subject>Biology and Life Sciences</subject><subject>Cohort Studies</subject><subject>Data collection</subject><subject>Demographic aspects</subject><subject>Demographics</subject><subject>Drinking (Alcoholic beverages)</subject><subject>Drug abuse</subject><subject>Female</subject><subject>Health risks</subject><subject>Health sciences</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - psychology</subject><subject>HIV tests</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Incidence</subject><subject>Infections</subject><subject>Marriage</subject><subject>Medical tests</subject><subject>Medicine and Health Sciences</subject><subject>People and Places</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - epidemiology</subject><subject>Pregnancy Complications, Infectious - psychology</subject><subject>Pregnant women</subject><subject>Prevention</subject><subject>Prophylaxis</subject><subject>Questionnaires</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Risk taking</subject><subject>Seroconversion</subject><subject>Setting (Literature)</subject><subject>Sex</subject><subject>Sexual Behavior</subject><subject>Sexual partners</subject><subject>Sexually transmitted disease prevention</subject><subject>Sexually transmitted diseases</subject><subject>Social Sciences</subject><subject>Sociodemographics</subject><subject>STD</subject><subject>Studies</subject><subject>Testing</subject><subject>Uganda - epidemiology</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk21rFDEQxxdRbD39BqIBQRS8M8lu9uGNUOpDDwsFbfs2zGZn93LuJmeS8-Hbm_O25Vb6QvIiYfKb_2RmMknylNEFSwv2dm23zkC_2FiDC8rTjBXZveSYVSmf55ym9w_OR8kj79eUirTM84fJUcoF5ZwXx0l9uUKijdINGoXEtuRseU3ANAS8t0pDwIY47b-RFlSwzhMYrOnIxmFnwATy0w5oogL5DDU42yN5r31wWoU35KqLQvA4edBC7_HJuM-Sq48fLk_P5ucXn5anJ-dzlVc8zFWJRSl4kRaqiksApZjVrcCGp01WVrzOkDGWC6YiRSuoy4bRlNdVyXPkIp0lz_e6m956OZbHS57RqiwoLapILPdEY2EtN04P4H5LC1r-NVjXSXBBqx6lEKrMa1UjKJ7xqimRQ0tZnmctchQqar0bo23rARuFJjjoJ6LTG6NXsrM_ZMGLLIv9miWvRgFnv2_RBzlor7DvwaDd7t4ds8sLUe0ye_EPend2I9VBTECb1sa4aicqT3IuyjSyLFKLO6i4Ghy0in-p1dE-cXg9cYhMwF-hg633cvn1y_-zF9dT9uUBu0Low8rbfhu0NX4KZntQOeu9w_a2yIzK3SjcVEPuRkGOoxDdnh026Nbp5u-nfwBhJgIu</recordid><startdate>20200605</startdate><enddate>20200605</enddate><creator>Schumann, Hannah</creator><creator>Rubagumya, Kenyonyozi</creator><creator>Rubaihayo, John</creator><creator>Harms, Gundel</creator><creator>Wanyenze, Rhoda K</creator><creator>Theuring, Stefanie</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5372-7903</orcidid></search><sort><creationdate>20200605</creationdate><title>The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda</title><author>Schumann, Hannah ; Rubagumya, Kenyonyozi ; Rubaihayo, John ; Harms, Gundel ; Wanyenze, Rhoda K ; Theuring, Stefanie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-c8e7852737c9c9c5a00e4bf5ed23d4892b4e111651c52709ab8d1032b9826e253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abuse</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Alcohol abuse</topic><topic>Alcohol use</topic><topic>Alcoholism</topic><topic>Biology and Life Sciences</topic><topic>Cohort Studies</topic><topic>Data collection</topic><topic>Demographic aspects</topic><topic>Demographics</topic><topic>Drinking (Alcoholic beverages)</topic><topic>Drug abuse</topic><topic>Female</topic><topic>Health risks</topic><topic>Health sciences</topic><topic>HIV</topic><topic>HIV infections</topic><topic>HIV Infections - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schumann, Hannah</au><au>Rubagumya, Kenyonyozi</au><au>Rubaihayo, John</au><au>Harms, Gundel</au><au>Wanyenze, Rhoda K</au><au>Theuring, Stefanie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-06-05</date><risdate>2020</risdate><volume>15</volume><issue>6</issue><spage>e0234174</spage><epage>e0234174</epage><pages>e0234174-e0234174</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The study attempted to determine the incidence of HIV among pregnant women in Kabarole District, Uganda, and to identify socio-demographic and behavioral risk factors for seroconversion during pregnancy.
We carried out a retrospective cohort study among women for whom a documented HIV-negative test result from the first pregnancy trimester could be confirmed using available records, and who were HIV-retested in the third trimester or during delivery. In total, 1610 pregnant women from three different healthcare settings took part in the study. We captured the results of repeated HIV tests and conducted semi-structured interviews to explore participants' socio-demographic characteristics and sexual risk behavior. For HIV incidence rates, we calculated the number of seroconversions per 100 person-years. We used Fisher's exact test to test for potential associations. Penalized maximum likelihood logistic regression and Poisson regression were applied to adjust for potential confounders.
The overall HIV incidence rate among participants was 2.9/100 women-years. Among socio-demographic characteristics, the multivariable analysis showed a significant association of marital status with HIV incidence in pregnancy (IRR 8.78, 95%CI [1.13-68.33]). Risky sexual behaviors including higher number of sexual partners in pregnancy (IRR 2.78 [1.30-5.94]), unprotected sex with unknown persons (IRR 14.25 [4.52-44.93]), alcohol abuse (IRR 12.08 [4.18-34.90]) and sex under the influence of drugs or alcohol (IRR 6.33 [1.36-29.49]) were significantly associated with seroconversion in pregnancy (similar results in logistic regression).
HIV incidence was three times higher among our pregnant study population compared to the general female population in Uganda. This underlines the importance of HIV prevention and repeat testing during pregnancy. Identified risk groups should be considered for pre-exposure prophylaxis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32502227</pmid><doi>10.1371/journal.pone.0234174</doi><tpages>e0234174</tpages><orcidid>https://orcid.org/0000-0002-5372-7903</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2020-06, Vol.15 (6), p.e0234174-e0234174 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Abuse Adolescent Adult Alcohol abuse Alcohol use Alcoholism Biology and Life Sciences Cohort Studies Data collection Demographic aspects Demographics Drinking (Alcoholic beverages) Drug abuse Female Health risks Health sciences HIV HIV infections HIV Infections - epidemiology HIV Infections - psychology HIV tests Hospitals Human immunodeficiency virus Humans Identification methods Incidence Infections Marriage Medical tests Medicine and Health Sciences People and Places Population studies Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - psychology Pregnant women Prevention Prophylaxis Questionnaires Regression analysis Retrospective Studies Risk analysis Risk Factors Risk groups Risk taking Seroconversion Setting (Literature) Sex Sexual Behavior Sexual partners Sexually transmitted disease prevention Sexually transmitted diseases Social Sciences Sociodemographics STD Studies Testing Uganda - epidemiology Womens health Young Adult |
| title | The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T06%3A57%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20incidence%20of%20HIV%20and%20associated%20risk%20factors%20among%20pregnant%20women%20in%20Kabarole%20District,%20Uganda&rft.jtitle=PloS%20one&rft.au=Schumann,%20Hannah&rft.date=2020-06-05&rft.volume=15&rft.issue=6&rft.spage=e0234174&rft.epage=e0234174&rft.pages=e0234174-e0234174&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0234174&rft_dat=%3Cgale_plos_%3EA625832401%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2409870079&rft_id=info:pmid/32502227&rft_galeid=A625832401&rft_doaj_id=oai_doaj_org_article_55c86bcbeac2429d8e2af01664fe2e5c&rfr_iscdi=true |