-in sub-Saharan Africa
[NATIONAL PRESS FOUNDATION] –  Sixty per cent of all people living with HIV in sub-Saharan Africa are women.  And the number of women — particularly of child-bearing age — receiving antiretroviral therapy (ART) is steadily rising. 
But does ART lead to more pregnancies? 

To answer that question, researchers from Cape Town University and Columbia University analyzed data from the Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative, “a multi-country HIV care and treatment program for women, children, and families.” Specifically, the researchers looked at the rates of pregnancy before and after women began treatment.

The study is published this month in the online journal, PLoS Medicine. 

“Over a four-year period, nearly a third of the women starting ART experienced a pregnancy: 244 pregnancies occurred in the ‘pre-ART’ group (women not receiving ART) compared to 345 pregnancies in the ‘on-ART’ group (women receiving ART). The chance of pregnancy increased over time in the on-ART group to almost 80% greater than the pre-ART group, while remaining relatively low and constant in the pre-ART group.”

Now the question remains: Why?    The study’s authors note that while their research does indicate that ART is associated with higher pregnancy rates, “the reasons for this link are unclear. One possible explanation is behavioural: Women receiving ART may feel more motivated to have children as their health and quality of life improve. However, the study did not examine how pregnancy desires and sexual activity of women changed while on ART, and cannot discern why ART is linked to increased pregnancy.”

Nonetheless, the researchers say the results point to a need for better counselling and pregnancy-related care in combination with ART:
“Understanding how pregnancy rates vary in HIV-infected women receiving ART helps support the formation of responsive, effective HIV programmes. Female HIV patients of child-bearing age, who form the majority of patients receiving ART in sub-Saharan Africa, would benefit from programmes that combine starting HIV treatment with ART with education and contraception counseling and pregnancy-related care.”

Let’s have your views

Hello Readers,
Interesting, isn’t it?   Or, should I say, thought-provoking?  Well, this article, which appeared on the Washington-based National Press Foundation’s [NPF] blogsite is certainly whipping up interest in many quarters. 

Whilst the findings are based on a study done specifically in sub-Saharan Africa, it might not be surprising to find that this situation obtains in other in other countries where Anti-retroviral (ART) treatment is being rolled out. 

Interestingly enough, this observation has been made by a few women on ART here in Guyana, but since no study was carried out to determine its frequency, we at the HIV/AIDS Mailbox merely considered them to be isolated cases.

But what’s more, our information is that at least two of these pregnancies have resulted between sero-discordant couples (where one partner is HIV-positive and the other negative), and after conception, the HIV-negative partner continued to test negative.

Perhaps you or someone you know may have had a similar experience.  If so, why not share your experience with us anonymously (without mentioning names),  and give us your opinion as to what might be responsible for more pregnancies being recorded among women on Anti-retroviral therapy (ART) 

We also invite our medical experts to share any information they may have with us on this interesting development, even commenting on the implications. 

Responses will be posted in our weekly column, commencing next Sunday.

Thanks in advance for your usual cooperation, and do begin mailing your responses, as soon as possible, to: HIV/AIDS Mailbox, Guyana Chronicle, Lama Avenue, Bel Air Park, Georgetown, or e-mail us at waronhiv@yahoo.com

Looking forward, as always, for those letters, as this is intended to be a topic generating much interaction.
Shirla