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Incidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study

dc.rights.licenseopenen_US
dc.contributor.authorDAHOUROU, Desire Lucien
dc.contributor.authorTISSERON, Clement
dc.contributor.authorYONABA, Caroline
dc.contributor.authorDJAHA, Joel
dc.contributor.authorN'GBECHE, Marie-Sylvie
dc.contributor.authorMOH, Corinne
dc.contributor.authorKOUADIO, Kouakou
dc.contributor.authorNINDJIN, Patricia
dc.contributor.authorEBOUA, Francois
dc.contributor.authorBOUAH, Belinda
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorMALATESTE, Karen
dc.contributor.authorAZANI, Jean-Claude
dc.contributor.authorKANGAH, Eulalie
dc.contributor.authorTHIO, Elisabeth
dc.contributor.authorMSELLATI, Philippe
dc.contributor.authorJESSON, Julie
dc.contributor.authorLEROY, Valeriane
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorDABIS, Francois
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorBECQUET, Renaud
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorBERNARD, Charlotte
ORCID: 0000-0003-2677-4023
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorCHASSAGNE, Shino
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorJAQUET, Antoine
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorRABOURDIN, E.
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorTIENDREBEOGO, T.
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorDESMONDE, Sophie
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorEKOUEVI, Didier Koumavi
dc.date.accessioned2025-04-14T11:47:22Z
dc.date.available2025-04-14T11:47:22Z
dc.date.issued2025-01-30
dc.identifier.issn1471-2458en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206182
dc.description.abstractEnBACKGROUND: 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).
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subject.enAdolescent
dc.subject.enBurkina Faso
dc.subject.enCôte d’Ivoire
dc.subject.enHIV
dc.subject.enIncidence
dc.subject.enPregnancy
dc.subject.enQualitative research
dc.subject.enSexual and reproductive health
dc.title.enIncidence of unintended pregnancies and pregnancy experience among adolescents living with perinatally-acquired HIV in West Africa: a mixed-method study
dc.title.alternativeBMC Public Healthen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1186/s12889-025-21595-wen_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39885473en_US
bordeaux.journalBMC Public Healthen_US
bordeaux.page385en_US
bordeaux.volume25en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
bordeaux.identifier.funderIDAgence Nationale de Recherches sur le Sida et les Hépatites Viralesen_US
bordeaux.identifier.funderIDInstitut National Du Canceren_US
bordeaux.identifier.funderIDEunice Kennedy Shriver National Institute of Child Health and Human Developmenten_US
bordeaux.identifier.funderIDNational Institute of Allergy and Infectious Diseasesen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMC%20Public%20Health&rft.date=2025-01-30&rft.volume=25&rft.issue=1&rft.spage=385&rft.epage=385&rft.eissn=1471-2458&rft.issn=1471-2458&rft.au=DAHOUROU,%20Desire%20Lucien&TISSERON,%20Clement&YONABA,%20Caroline&DJAHA,%20Joel&N'GBECHE,%20Marie-Sylvie&rft.genre=article


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