Susan B. Brogly ^1*, D. Heather Watts ², Nathalie Ylitalo ¹, Eduardo L. Franco ³, George R. Seage ¹, James Oleske ⁴, Michelle Eagle ⁵, Russell Van Dyke ⁶

¹ Harvard School of Public Health
² National Institute of Child Health & Human Development
³ McGill University
⁴ University of Medicine & Dentistry of New Jersey
⁵ University of Florida
⁶ Tulane University Health Science Center

^* To whom correspondence should be addressed. E-mail: sbrogly{at}sdac.harvard.edu.

	Abstract

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

Methods. The incidence of first pregnancy, genital infections, and abnormal cervical cytology was estimated 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 higher than among HIV-uninfected adolescents. These findings underscore the importance of Papanicolaou tests and promotion of safer sexual practices in this population.

Key Words: Adolescent Health, HIV/AIDS, Birth Outcomes, Pregnancy, Sexual Health

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