© 2007 American Public Health Association DOI: 10.2105/AJPH.2005.071910
Susan B. Brogly is with the Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Mass. D. Heather Watts is with the Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, Bethesda, Md. Nathalie Ylitalo and George R. Seage III are with the Department of Epidemiology, Harvard School of Public Health, Boston. Eduardo L. Franco is with the Departments of Epidemiology and Biostatistics and of Oncology, McGill University, Montreal, Quebec. James Oleske is with the Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark. Michelle Eagle is with the Division of Pediatric Infectious Disease and Immunology, University of Florida, Gainesville. Russell Van Dyke is with the Department of Pediatrics, Tulane University Health Science Center, New Orleans, La. Correspondence: Requests for reprints should be sent to Susan B. Brogly, PhD, Center for Biostatistics in AIDS Research, Harvard School of Public Health, 651 Huntington Ave, Boston, MA 021156017 (e-mail: sbrogly{at}sdac.harvard.edu).
Objectives. We sought to describe the reproductive health of adolescent girls perinatally infected with HIV. Methods. We estimated the incidence of first pregnancy, genital infections, and abnormal cervical cytology for 638 girls aged 13 years and older in the Pediatric AIDS Clinical Trials Group protocol 219C. Results. Thirty-eight girls became pregnant, for a first pregnancy rate of 18.8/ 1000 person-years; 7 of these girls had additional pregnancies (95% confidence interval [CI]=13.3, 25.7). Thirty-two pregnancies resulted in live births. All girls received antiretroviral therapy during pregnancy. One infant was HIV infected, 29 were uninfected, and 2 had unknown infection status, for a rate of mother-to-child transmission of HIV in infants with known infection status of 3.3% (95% CI=0.1, 18.6). Condylomata and trichomoniasis were the most frequent genital infections. Forty-eight (47.5%) of 101 girls with Papanicolaou test examinations had abnormal cervical cytology, including atypical cells of undetermined significance (n=18), low-grade squamous intraepithelial lesions (SIL; n=27), and high-grade SIL (n=3). Many abnormalities persisted despite intervention. Conclusions. Pregnancy rates were lower and cervical abnormalities were higher than among nonHIV-infected adolescents. These findings underscore the importance of Papanicolaou tests and promotion of safer sexual practices in this population. This article has been cited by other articles:
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