Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study
Abstract Background Sexual and reproductive health issues in adolescents living with HIV (ALHIV) have been left behind in HIV care programs. ALHIV are at risk of unintended pregnancy which jeopardizes their socio-economic future, health outcomes and exposes their newborn to HIV transmission. A bette...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-21595-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571261032595456 |
|---|---|
| author | Désiré Lucien Dahourou Clément Tisseron Caroline Yonaba Joël Djaha Marie-Sylvie N’Gbeche Corinne Moh Kouakou Kouadio Patricia Nindjin François Eboua Belinda Bouah Karen Malateste Jean-Claude Azani Eulalie Kangah Elisabeth Thio Philippe Msellati Julie Jesson Valériane Leroy for the IeDEA West-African Collaboration |
| author_facet | Désiré Lucien Dahourou Clément Tisseron Caroline Yonaba Joël Djaha Marie-Sylvie N’Gbeche Corinne Moh Kouakou Kouadio Patricia Nindjin François Eboua Belinda Bouah Karen Malateste Jean-Claude Azani Eulalie Kangah Elisabeth Thio Philippe Msellati Julie Jesson Valériane Leroy for the IeDEA West-African Collaboration |
| author_sort | Désiré Lucien Dahourou |
| collection | DOAJ |
| description | Abstract Background Sexual and reproductive health issues in adolescents living with HIV (ALHIV) have been left behind in HIV care programs. ALHIV are at risk of unintended pregnancy which jeopardizes their socio-economic future, health outcomes and exposes their newborn to HIV transmission. A better understanding of these events is needed. We studied the 18-month pregnancy incidence, and explored experiences of pregnancy among female ALHIV enrolled in the OPTIMISE-AO cohort, nested in the prospective paediatric IeDEA cohort in Côte d’Ivoire and Burkina Faso. Methods We conducted a mixed-method study nested in the OPTIMISE-AO-ANRS-12390 project, a stepped-wedge interventional trial launched in 2021 to support HIV-disclosure and antiretroviral treatment (ART) adherence in assenting ALHIV aged 10–17 years in Abidjan, Cote d’Ivoire and Ouagadougou, Burkina Faso. We estimated the 18-month incidence rate of pregnancy per 100 woman-years (WY) among those older than 14 years at inclusion. In Abidjan, semi-structured interviews were also conducted with eight adolescents who became pregnant since their inclusion to report their pregnancy experience. Results After 18 months of follow-up, 12 pregnancies occurred among the 111 ALHIV followed up over 153 WY, yielding an overall pregnancy incidence of 7.8/100 WY (95% confidence interval [95%CI]: 4.4–13.7). Stratified by age at enrolment, it was 2.2 (95%CI: 0.3–15.5), 7.6 (95%CI: 2.8–20.3), 13.1 (95%CI:5.4–31.4), 11.5 (95%CI: 2.8–45.8) per 100 WY in those aged 14, 15, 16, and 17 years, respectively. After birth, all the newborns (12/12) had received prevention of HIV mother-to-child transmission ART, and were HIV-negative at the 6-week early infant HIV diagnosis. The eight ALHIV interviewed shared that the discovery of their pregnancy, all unintended, was a shock, and led to negative consequences, such as rejection from their family, and stigmatisation. Most attempted to terminate their pregnancy unsuccessfully. They reported major financial challenges associated with their pregnancy that forced them to find a job rather than going back to school after delivery. Conclusions In West Africa, the incidence of unintended pregnancy was high among female ALHIV and resulted in negative socioeconomic outcomes. HIV care programs should include interventions that improve awareness and access to sexual and reproductive healthcare, including contraception, to meet the needs of ALHIV in West Africa. Trial registration Registered with the Pan African Clinical Trials Registry on 13 February 2024 (reference no. PACTR202402863175053). |
| format | Article |
| id | doaj-art-b61502f512b64d579cc84914160f09b0 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-b61502f512b64d579cc84914160f09b02025-02-02T12:46:05ZengBMCBMC Public Health1471-24582025-01-0125111110.1186/s12889-025-21595-wIncidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method studyDésiré Lucien Dahourou0Clément Tisseron1Caroline Yonaba2Joël Djaha3Marie-Sylvie N’Gbeche4Corinne Moh5Kouakou Kouadio6Patricia Nindjin7François Eboua8Belinda Bouah9Karen Malateste10Jean-Claude Azani11Eulalie Kangah12Elisabeth Thio13Philippe Msellati14Julie Jesson15Valériane Leroy16for the IeDEA West-African CollaborationDépartement Biomédical Et de Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS/CNRST)Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse IIIUniversité Joseph Ki-ZerboUniversité Félix Houphouët-BoignyCePReFCePReFCIRBACIRBACentre de Traitement Ambulatoire Pédiatrique, CHU YopougonCentre de Traitement Ambulatoire Pédiatrique, CHU YopougonBordeaux Population Health - Centre INSERM U1219, Université de BordeauxProgramme ANRS-PACCIProgramme ANRS-PACCICentre de Recherche Internationale pour la SantéProgramme ANRS-PACCICenter for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse IIICenter for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse IIIAbstract Background Sexual and reproductive health issues in adolescents living with HIV (ALHIV) have been left behind in HIV care programs. ALHIV are at risk of unintended pregnancy which jeopardizes their socio-economic future, health outcomes and exposes their newborn to HIV transmission. A better understanding of these events is needed. We studied the 18-month pregnancy incidence, and explored experiences of pregnancy among female ALHIV enrolled in the OPTIMISE-AO cohort, nested in the prospective paediatric IeDEA cohort in Côte d’Ivoire and Burkina Faso. Methods We conducted a mixed-method study nested in the OPTIMISE-AO-ANRS-12390 project, a stepped-wedge interventional trial launched in 2021 to support HIV-disclosure and antiretroviral treatment (ART) adherence in assenting ALHIV aged 10–17 years in Abidjan, Cote d’Ivoire and Ouagadougou, Burkina Faso. We estimated the 18-month incidence rate of pregnancy per 100 woman-years (WY) among those older than 14 years at inclusion. In Abidjan, semi-structured interviews were also conducted with eight adolescents who became pregnant since their inclusion to report their pregnancy experience. Results After 18 months of follow-up, 12 pregnancies occurred among the 111 ALHIV followed up over 153 WY, yielding an overall pregnancy incidence of 7.8/100 WY (95% confidence interval [95%CI]: 4.4–13.7). Stratified by age at enrolment, it was 2.2 (95%CI: 0.3–15.5), 7.6 (95%CI: 2.8–20.3), 13.1 (95%CI:5.4–31.4), 11.5 (95%CI: 2.8–45.8) per 100 WY in those aged 14, 15, 16, and 17 years, respectively. After birth, all the newborns (12/12) had received prevention of HIV mother-to-child transmission ART, and were HIV-negative at the 6-week early infant HIV diagnosis. The eight ALHIV interviewed shared that the discovery of their pregnancy, all unintended, was a shock, and led to negative consequences, such as rejection from their family, and stigmatisation. Most attempted to terminate their pregnancy unsuccessfully. They reported major financial challenges associated with their pregnancy that forced them to find a job rather than going back to school after delivery. Conclusions In West Africa, the incidence of unintended pregnancy was high among female ALHIV and resulted in negative socioeconomic outcomes. HIV care programs should include interventions that improve awareness and access to sexual and reproductive healthcare, including contraception, to meet the needs of ALHIV in West Africa. Trial registration Registered with the Pan African Clinical Trials Registry on 13 February 2024 (reference no. PACTR202402863175053).https://doi.org/10.1186/s12889-025-21595-wSexual and reproductive healthAdolescentHIVCôte d’IvoireBurkina FasoPregnancy |
| spellingShingle | Désiré Lucien Dahourou Clément Tisseron Caroline Yonaba Joël Djaha Marie-Sylvie N’Gbeche Corinne Moh Kouakou Kouadio Patricia Nindjin François Eboua Belinda Bouah Karen Malateste Jean-Claude Azani Eulalie Kangah Elisabeth Thio Philippe Msellati Julie Jesson Valériane Leroy for the IeDEA West-African Collaboration Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study BMC Public Health Sexual and reproductive health Adolescent HIV Côte d’Ivoire Burkina Faso Pregnancy |
| title | Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study |
| title_full | Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study |
| title_fullStr | Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study |
| title_full_unstemmed | Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study |
| title_short | Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study |
| title_sort | incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally acquired hiv in west africa a mixed method study |
| topic | Sexual and reproductive health Adolescent HIV Côte d’Ivoire Burkina Faso Pregnancy |
| url | https://doi.org/10.1186/s12889-025-21595-w |
| work_keys_str_mv | AT desireluciendahourou incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT clementtisseron incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT carolineyonaba incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT joeldjaha incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT mariesylviengbeche incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT corinnemoh incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT kouakoukouadio incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT patricianindjin incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT francoiseboua incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT belindabouah incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT karenmalateste incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT jeanclaudeazani incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT eulaliekangah incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT elisabeththio incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT philippemsellati incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT juliejesson incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT valerianeleroy incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy AT fortheiedeawestafricancollaboration incidenceofunintendedpregnanciesandpregnancyexperienceamongadolescentslivingwithperinatallyacquiredhivinwestafricaamixedmethodstudy |