14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 27.014 Session: HIV: Epidemiology and Prevention Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Factors influencing pregnancy among HIV positive women receiving anti-retroviral therapy in Tororo district, Uganda M. Busuulwa Medical Epidemiologist, Kampala, US, Uganda Background: In Uganda HIV prevalence among women is estimated at 7.5% relative to 5.0% among men. The women are disproportionately affected at the younger age compared with men. This therefore has an implication on their fertility in the era of anti-retroviral therapy (ART). The improvement in health in the advent of ART has resulted in high proportions of unplanned pregnancies in HIV positive women on treatment estimated at 97%. Purpose of study: establish factors for unplanned pregnancies among HIV positive women on ART care to help health district department implement and strengthen family planning services in HIV care in Tororo District and prevent unplanned pregnancies in women with HIV/AIDS on ART to improve their quality of life. Methods: Facility based unmatched case control study. Cases were women who had an unplanned pregnancy or had ever had one whilst on ART; controls were women on ART who had never had an unplanned pregnancy. Sample size was 414 with 207 cases and 207controls. Results: Age 31years (OR= 1.70, 95% CI =1.140-2.53), seeking FP information (p=0.004), barriers to FP use (p= 0.00001) and provision of male condoms (p=0.00004) by the ART clinics were significantly associated with unplanned pregnancies in HIV positive women on ART. On the other hand, using injectable hormonal FP (p= 0.00002) and dual contraceptives (OR = 0.22 95% CI=0.12- 0.41) was associated with less likelihood of occurrence of unplanned pregnancies Conclusion: Age31years; seeking FP information from health workers and presence barriers to FP use were risk factors to unplanned pregnancies. On the other hand, using male condoms alone;using dual FP methods of contraception was protective against unplanned pregnancies in HIV positive women on ART. Providing comprehensive family planning in HIV/AIDS care settings is necessary to reduce/prevent unplanned pregnancies in HIV+ women.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 27.015 Session: HIV: Epidemiology and Prevention Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Epidemiologic characteristics and transmitted drug resistance mutation patterns among newly diagnosed HIV infected individuals in a large tertiary care hospital in Detroit M. Huaman, J. Aguilar, N. Markowitz, D. Baxa, A. Golembieski, I. Brar Henry Ford Hospital, Detroit, MI, USA Background: Although evidence is mounting for earlier initiation of antiretroviral therapy, late presentation and transmitted drug resistance are major obstacles for current treatment and prevention strategies. We describe the epidemiology and transmitted drug resistance mutation patterns of newly diagnosed HIV individuals in a large tertiary care hospital in Detroit. Methods: A retrospective analysis among adults newly diagnosed with HIV infection was performed using a computer-based medical record system. Individuals who received care at Henry Ford Hospital at the time of diagnosis and underwent genotypic resistance testing were included. Demographic, clinical and laboratory data were collected. Drug resistance mutations were detected using the Trugene HIV-1 genotype assay. Mutations evaluated were selected from the IAS-USA mutation list (12/2008). Results: From 01/2006-12/2008, 137 individuals were newly diagnosed with HIV and underwent genotypic resistance testing. Mean age was 37 years; 75% were male; 77% African-Americans. Transmission risk in males: 60% MSM, 35% high-risk heterosexual, 2% injection drug use (IDU). Transmission risk in females: 79% high-risk heterosexual, 9% IDU. Overall, 53% were diagnosed in outpatient clinics, 29% during a hospital admission, and 10% in the Emergency Department. Reasons for HIV testing included: symptoms suspicious for immunosupression in 45%; routine checkup for 29%; suspected sexually transmitted disease in 14%, partner notification/recent highrisk sexual contact in 12%. At the time of diagnosis, 30% had an opportunistic disease: 14% Pneumocystis pneumonia; 10% esophageal candidiasis. Mean CD4 count was 272 cells/mm3; 47% of patients had 200 CD4 cells/mm3; 35% had a viral load >100,000 copies/ml. Prevalence of transmitted drug resistance mutations was 18.9%. Prevalence of one, two and three class mutations were 13.1%, 5.1% and 0.7% respectively. NNRTI resistance mutations occurred in 11% (K103N in 8%); 7% had PI resistance mutations (L90M in 5%); and 7% had NRTI resistance mutations. Bivariate and multivariate analyses showed no significant associations between resistance mutations and demographic variables. Conclusion: Late presentation and transmitted drug resistance mutations are common among newly diagnosed HIV infected individuals in Detroit. There is a high burden of disease among young and heterosexual populations. Scaling up of programs to diagnose HIV infection in a timely manner is essential for appropriate treatment intervention and enhanced preventive efforts.
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