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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.071910v1 97/6/1047    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Brogly, S. B. Articles by Van Dyke, R. Search for Related Content PubMed PubMed Citation Articles by Brogly, S. B. Articles by Van Dyke, R. Related Collections HIV/AIDS Adolescent Health Birth Outcomes Pregnancy Sexual Health

Susan B. Brogly, PhD, D. Heather Watts, MD, Nathalie Ylitalo, MD, Eduardo L. Franco, PhD, George R. Seage, III, ScD, James Oleske, MD, Michelle Eagle, PA-C and Russell Van Dyke, MD

Susan B. Brogly is with the Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Mass. D. Heather Watts is with the Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, Bethesda, Md. Nathalie Ylitalo and George R. Seage III are with the Department of Epidemiology, Harvard School of Public Health, Boston. Eduardo L. Franco is with the Departments of Epidemiology and Biostatistics and of Oncology, McGill University, Montreal, Quebec. James Oleske is with the Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark. Michelle Eagle is with the Division of Pediatric Infectious Disease and Immunology, University of Florida, Gainesville. Russell Van Dyke is with the Department of Pediatrics, Tulane University Health Science Center, New Orleans, La.

Correspondence: Requests for reprints should be sent to Susan B. Brogly, PhD, Center for Biostatistics in AIDS Research, Harvard School of Public Health, 651 Huntington Ave, Boston, MA 02115–6017 (e-mail: sbrogly{at}sdac.harvard.edu).

Objectives. We sought to describe the reproductive health of adolescent girls perinatally infected with HIV.

Methods. We estimated the incidence of first pregnancy, genital infections, and abnormal cervical cytology for 638 girls aged 13 years and older in the Pediatric AIDS Clinical Trials Group protocol 219C.

Results. Thirty-eight girls became pregnant, for a first pregnancy rate of 18.8/ 1000 person-years; 7 of these girls had additional pregnancies (95% confidence interval [CI]=13.3, 25.7). Thirty-two pregnancies resulted in live births. All girls received antiretroviral therapy during pregnancy. One infant was HIV infected, 29 were uninfected, and 2 had unknown infection status, for a rate of mother-to-child transmission of HIV in infants with known infection status of 3.3% (95% CI=0.1, 18.6). Condylomata and trichomoniasis were the most frequent genital infections. Forty-eight (47.5%) of 101 girls with Papanicolaou test examinations had abnormal cervical cytology, including atypical cells of undetermined significance (n=18), low-grade squamous intraepithelial lesions (SIL; n=27), and high-grade SIL (n=3). Many abnormalities persisted despite intervention.

Conclusions. Pregnancy rates were lower and cervical abnormalities were higher than among non–HIV-infected adolescents. These findings underscore the importance of Papanicolaou tests and promotion of safer sexual practices in this population.

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