ArticlePloS one2018
HIV incidence among pregnant and postpartum women in a high prevalence setting.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Acceptability, Needs, Concerns, and Barriers to Digital-Based Interventions for the Prevention of Mother-to-Child Transmission of HIV: Systematic Review and Qualitative Meta-Aggregation.JMIR medical informatics · 2025Pooled it
- Pooled it
- Vaginal Microbiota and Cytokines Among Pregnant and Breastfeeding Women in Clinical Trials of the Dapivirine Vaginal Ring and Oral Tenofovir Disoproxil Fumarate/Emtricitabine.Open forum infectious diseases · 2026Trial
- Trial
- Depression Among Pregnant and Breastfeeding Persons Participating in Two Randomized Trials of the Dapivirine Vaginal Ring and Oral Pre-Exposure Prophylaxis (PrEP) in Malawi, South Africa, Uganda, and Zimbabwe.AIDS and behavior · 2024Trial
- DELIVER: A Safety Study of a Dapivirine Vaginal Ring and Oral PrEP for the Prevention of HIV During Pregnancy.Journal of acquired immune deficiency syndromes (1999) · 2024Trial
- Developing a surveillance system for HIV pre-exposure prophylaxis (PrEP) use in pregnancy in Malawi.BMC pregnancy and childbirth · 2026Article
- Article
- Prevalence and factors associated with uptake of repeat HIV testing among pregnant women in Blantyre, Malawi.BMC public health · 2026Article
- Comparison of infant feeding practices by maternal HIV status, and associated factors, in a rural district, South Africa 2019.International breastfeeding journal · 2025Article
- Preferences for and acceptability of long-acting HIV prevention products among pregnant and lactating women accessing health services in Kenya: a mixed method cross-sectional analysis.BMC infectious diseases · 2025Article
- Effectiveness of a multi-component facility-based intervention on HIV-related infant and maternal outcomes: results from the IMPROVE clustered randomized study.Frontiers in medicine · 2025Article
- Evaluating the performance of a risk assessment score tool to predict HIV acquisition among pregnant and postpartum women in Kenya.PloS one · 2024Article
- HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.Frontiers in reproductive health · 2024Article
- Article
- Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner's HIV status, in six South African districts with a high antenatal HIV burden.BMC public health · 2023Article
- Optimizing the pipeline of multipurpose prevention technologies: opportunities across women's reproductive lifespans.Frontiers in reproductive health · 2023Review
- Incident HIV acquisition among pregnant women in Botswana: findings from the Tsepamo birth outcomes surveillance study.Journal of the International AIDS Society · 2023Article
- Birth Preparedness Plans and Status Disclosure Among Pregnant Women Living with HIV Who are Receiving Antiretroviral Therapy in Ibadan, Southwest, Nigeria.International journal of MCH and AIDS · 2023Article
- Understanding the role of men in women's use of the vaginal ring and oral PrEP during pregnancy and breastfeeding: multi-stakeholder perspectives.African journal of AIDS research : AJAR · 2022Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In sub-Saharan Africa, most women who test HIV negative at the first antenatal care encounter are rarely tested again during pregnancy and postpartum, yet data suggests that pregnancy is associated with increased risk of HIV acquisition compared to non-pregnant women. We describe HIV incidence during pregnancy and postpartum in Lesotho, a high prevalence setting, and factors associated with HIV seroconversion. We enrolled a cohort of HIV negative women presenting at health facilities for antenatal care and followed them through delivery up to 24 months postpartum. Women were repeatedly tested for HIV according to the Lesotho Ministry of Health routine rapid HIV testing guidelines and responded to risk behavior questionnaire every three months. We estimated HIV incidence and associated 95% confidence intervals. We used mixed effects Cox regression models to identify independent factors associated with seroconversion accounting for repeated assessment. The estimated overall HIV incidence rate was 1.58 (95% CI: 1.05-2.28) per 100 person- years. The estimated HIV incidence rate during pregnancy (2.61 per 100 person-years, 95% CI: 1.12-5.14) was almost double the estimated HIV incidence during postpartum (1.36 per 100 person-years, 95% CI: 0.83-2.10). Women's age (14-24 years compared to 25-45 years), multiple sexual partnerships, urethral discharge and no condoms nor pre-exposure prophylaxis were independently associated with HIV infection. There is an increased need for counseling and support of HIV-uninfected pregnant and breastfeeding women to stay HIV-negative, including provision of pre-exposure prophylaxis during this high-risk period, particularly among adolescent and young women.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.