Prevention of mother-to-child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000-10
Thorne, C.; Semenenko, I.; Malyuta, R.; Pilipenko, T.; Zayats, A.; Khomout, Y.; Posokhova, S.; Kaleeva, T.; Barishnikova, Y.; Servetsky, S.; Tereshenko, R.; Stelmah, A.; Kiseleva, G.; Dotsenko, E.; Zalata, O..A.; Solokha, S.; Grazhdanov, M..P.; Kulakovskaya, E.; Bashkatova, N.; Gigil', V.; Raus, I.; Yurchenko, O..V.; Adejnova, I.; Ruban, Z.; Govorun, O.; Kochergina, I.; Ostrovskaya, L.; Primak, N.; Kvasha, L.; Kruglenko, G.
Addiction 107(1): 118-128
2012
ISSN/ISBN: 0965-2140 PMID: 21819473 DOI: 10.1111/j.1360-0443.2011.03609.xDocument Number: 535063
To compare clinical status, mother-to-child transmission (MTCT) rates, use of prevention of (PMTCT) interventions and pregnancy outcomes between HIV-infected injecting drug users (IDUs) and non-IDUs. Prospective cohort study conducted in seven human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Centres in Ukraine, 2000-10. Pregnant HIV-infected women, identified before/during pregnancy or intrapartum, and their live-born infants (n = 6200); 1028 women followed post-partum. Maternal and delivery characteristics, PMTCT prophylaxis, MTCT rates, preterm delivery (PTD) and low birth weight (LBW). Of 6200 women, 1111 (18%) reported current/previous IDU. The proportion of IDUs diagnosed with HIV before conception increased from 31% in 2000/01 to 60% in 2008/09 (P < 0.01). Among women with undiagnosed HIV at conception, 20% of IDUs were diagnosed intrapartum versus 4% of non-IDUs (P < 0.01). At enrolment, 14% of IDUs had severe/advanced HIV symptoms versus 6% of non-IDUs (P < 0.001). IDUs had higher rates of PTD and LBW infants than non-IDUs, respectively, 16% versus 7% and 22% versus 10% (P < 0.001). IDUs were more likely to receive no neonatal or intrapartum PMTCT prophylaxis compared with non-IDUs (OR 2.81, p < 0.001). MTCT rates were 10.8% in IDUs versus 5.9% in non-IDUs; IDUs had increased MTCT risk (adjusted odds ratio 1.32, P = 0.049). Fewer IDUs with treatment indications received HAART compared with non-IDUs (58% versus 68%, P = 0.03). Pregnant human immunodeficiency virus-infected injecting drug users in Ukraine have worse clinical status, poorer access to prevention of mother-to-child transmission prophylaxis and highly active antiretroviral therapy, more adverse pregnancy outcomes and higher risk of mother-to-child transmission than non-injecting drug user women.
Document emailed within 0-6 h
