Description of Sample

Table 1 shows a description of the sample. Women were predominantly African-American, single and had a mean age at diagnosis of 25 years (SD 5.9, range 14.0-38.1). Forty-one percent had less than a high-school education, half the sample had an income of <$6,000 a year and a third were employed at the time of diagnosis. The majority were Baptist and described themselves as being “somewhat religious.” Almost two-thirds of the women were diagnosed with HIV (Generic Viramune treating HIV infection) between the years 1986 and 1992. The rest were diagnosed between 1993 and 1996. Women were relatively healthy at diagnosis, with almost half having a first available CD4 count of >500. The predominant mode of HIV transmission was through heterosexual contact, followed by IV drug use. Most women reported never drinking alcohol or drinking only a few times a month or less. Forty-three percent said they had ever used a nonin-jecting drug at any time in their life. Among these, almost half had last used over a year ago. Over the course of the study period, 37% of the sample had a live birth, 13% experienced a pregnancy loss, 5% had an elective abortion, and almost half had a surgical sterilization subsequent to their HIV (Viramune canadian belongs to a class of HIV drugs) diagnosis.

Table 1. Description of sample (N=104)

Table 2 describes relationship characteristics, emotional support and desire for children among the women in the sample. Over half the women were in a relation­ship at the time of the interview with a mean of 4.7 years (SD 3.7, range 0.08-18.0) in the relationship. Among these, almost two-thirds had a partner who was HIV-negative, and the majority of women’s partners knew of their HIV (Zerit tablet treating HIV infection) status. Just over half of women’s partners wanted to have more children at the time of the interview. When asked about their current source of emotional support, partners and mothers were cited the most frequently, followed by self or no one. Of the over 200 children born to women in the sample over the course of the study period, only 8% were infected with HIV (Retrovir medication was the first drug approved for the treatment of HIV) and 4% had died (though only one had died due to HIV-related causes). Prior to diagnosis, 57% of the women reported that they had wanted more children, but only 36% said they currently wanted any more children.

Table 2. Relationships, emotional support and desire for children (N=104)

Pregnancy

Pregnant women (cases only) were also asked to discuss the circumstances of their pregnancies. Among the women who had a subsequent pregnancy, 55% said they had tried to prevent their first subsequent pregnancy, 12% said they had planned to get pregnant, and 33% said they had neither planned to get pregnant nor used contraception. In other words, 88% of these first subsequent pregnancies were unplanned.

Women who did not have a subsequent pregnancy were asked to discuss the circumstances sur rounding their reasons for not getting pregnant. A third of these women had wanted to get pregnant since their diagnosis, and 11% had actually tried to get pregnant. However, fully 83% said that they had made a conscious decision not to get pregnant, even though they may have wanted to. Sixty-three percent said their HIV (Generic Retrovir treating HIV infection) diagnosis greatly affected their decision. Over half the sample (56%) reported that they would have tried to get pregnant if they had not been HIV-positive.

Table 3. Bivariate characteristics (%) of women who became pregnant or had a surgical sterilization since HIV diagnosis

Comparisons of women who had a pregnancy subsequent to learning their HIV (Generic Zerit treating HIV infection) diagnosis with those who did not showed that pregnant women are predominantly unmarried, younger and have less than a high-school education compared to nonpregnant women (Table 3). Women who became pregnant were more likely to report being not at all or only somewhat religious. Pregnant women were also more likely to have been diagnosed earlier in the epidemic and to be healthier in terms of CD4 counts than nonpregnant women. Women who had a subsequent pregnancy were also more likely to have a recent history (within the past year) of noninjecting drug use. Pregnant and nonpregnant women did not differ significantly on whether they or their current partners wanted more children or on their partners’ HIV status.

A multivariate model was constructed using forward logistic regression to predict subsequent pregnancy (Table 4). All variables that had significant bivariate associations were included: age, marital status, year of HIV diagnosis, noninjecting drug use, CD4 count, education and religiosity. Age was protective, as increasing age reduced the odds of subsequent pregnancy. However, single women were 11.5 times as likely to have a subsequent pregnancy as nonsingle women, women diagnosed earlier in the epidemic were 3.5 times as likely to have a subsequent pregnancy as women diagnosed after 1993, and recent users of non-IV drugs were 6.6 times as likely to have a subsequent pregnancy as women who did not have recent drug use.

Table 4. Logistic regression model predicting pregnancy (n=104)*

Sterilization

Women who underwent a subsequent sterilization procedure were asked about their reasons for doing so. The majority of women (63%) stated that their HIV diagnosis influenced them a lot in their decision; 41% reported that they would have gotten sterilized even if they had not been infected.

Comparisons of women who had a surgical sterilization subsequent to learning their HIV diagnosis with those who did not showed that sterilized women are more likely to be employed, Baptist and have higher initial CD4 counts than nonsterilized women (Table 3). They were also less likely to be with a partner who desires a child (among those with a partner) and more likely to have already had a live birth subsequent to their HIV diagnosis.
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Table 5. Logistic regression model predicting sterilization (N=104)*

A multivariate model was constructed using forward logistic regression to predict subsequent sterilization (Table 5). All variables that had significant bivariate associations were included: employment status, CD4 count, religion, subsequent live birth and being with a partner who desires more children. Women who were Baptist were 2.6 times as likely to have undergone a sterilization procedure after learning their HIV diagnosis, and women who had had a live birth subsequent to their HIV diagnosis were 2.5 times as likely to have undergone a sterilization procedure after learning their HIV diagnosis.