Evidence map›Paper›PMID 34762836›Full record

ArticleThe lancet. HIV2021

Association of pregnancy with engagement in HIV care among women with HIV in the UK: a cohort study.

Hajra Okhai, Shema Tariq, Fiona Burns, Yvonne Gilleece, Rageshri Dhairyawan, Teresa Hill, Helen Peters, Claire Thorne, Caroline A Sabin, UK CHIC Steering Committee

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In one paragraph

Article in The lancet. HIV, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 56% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Hajra OkhaiInstitute for Global Health, University College London, London, UK; National Institute for Health Research Health Protection Research Unit in Blood-borne and Sexually Transmitted Infections, University College London, London, UK. Electronic address: h.okhai@ucl.ac.uk.
Shema TariqInstitute for Global Health, University College London, London, UK.
Fiona BurnsInstitute for Global Health, University College London, London, UK.
Yvonne GilleeceBrighton and Sussex University Hospitals NHS Trust, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK.
Rageshri DhairyawanDepartment of Infection and Immunity, Barts Health NHS Trust, London, UK.
Teresa HillInstitute for Global Health, University College London, London, UK.
Helen PetersInstitute for Global Health, University College London, London, UK; Integrated Screening Outcomes Surveillance Service, Great Ormond Street Institute of Child Health, University College London, London, UK.
Claire ThorneInstitute for Global Health, University College London, London, UK; Integrated Screening Outcomes Surveillance Service, Great Ormond Street Institute of Child Health, University College London, London, UK.
Caroline A SabinInstitute for Global Health, University College London, London, UK; National Institute for Health Research Health Protection Research Unit in Blood-borne and Sexually Transmitted Infections, University College London, London, UK.
UK CHIC Steering Committee
University College London · GBBarts Health NHS Trust · GBBrighton and Sussex Medical School · GBGreat Ormond Street Hospital · GBNational Institute for Health Research · GB

Funding

Medical Research Council G0600337Medical Research Council G0900274Medical Research Council MR/M004236/1
6 · The paper itself

Abstract

backgroundWomen with HIV face challenges in engaging in HIV care post partum. We aimed to examine changes in engagement in HIV care through clinic attendance before, during, and after pregnancy, compared with matched women with HIV who had never had a recorded pregnancy.

methodsIn this cohort study, we describe changes in engagement in HIV care before, during, and after pregnancy among women with HIV from the UK Collaborative HIV Cohort (CHIC) study from 25 HIV clinics in the UK with a livebirth reported to the National Surveillance of HIV in Pregnancy and Childhood between Jan 1, 2000, and Dec 31, 2017. To investigate whether changes were specific to HIV, we compared these changes to those over equivalent periods among non-pregnant women with HIV in the UK CHIC study matched for ethnicity, year of conception, age, CD4 cell count, viral suppression, and antiretroviral therapy use. Analyses were via logistic regression using generalised estimated equations with an interaction between case-control status (pregnant women vs non-pregnant women) and pregnancy or pseudo pregnancy (for non-pregnant women) stage.

findings1116 matched pairs of pregnant and non-pregnant women were included (median age 34 years [IQR 30-38], 80·1% Black African, 12·5% white). 69 330 person-months of follow-up were recorded, 25 412 in the before stage, 18 897 during, and 25 021 after pregnancy or pseudo pregnancy stages. Among pregnant women, the proportion of time engaged in care increased during pregnancy (8477 [90·5%] of 9371 person-months) and after pregnancy (10 501 [84·6%] of 12 407), compared with before pregnancy (9979 [78·5%] of 12 707). Among non-pregnant women in the control group, engagement in HIV care remained stable across the three equivalent stages (9688 [76·3%] of 12 705 person-months before pseudo pregnancy; 7463 [78·3%] of 9526 during pseudo pregnancy; and 9892 [78·4%] of 12 614 after pseudo pregnancy). The association of engagement in HIV care with pregnancy or pseudo pregnancy stage differed significantly by case-control status (p

interpretationWomen with HIV and a pregnancy resulting in a livebirth were more likely to engage in HIV care post partum when compared with before pregnancy. A detailed understanding of the reason for this finding could support interventions to maximise engagement in HIV care for all women with HIV.

fundingMedical Research Council and National Institute for Health Research.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousAdultCD4 Lymphocyte CountChildCohort StudiesFemaleHumansPregnancyUnited Kingdom

Identifiers

PMID34762836
OpenAlexW3212197694

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.