AEGiS-15IAC: HIV infection and reproductive health in teenage women orphaned and made vulnerable by AIDS in eastern Zimbabwe.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV infection and reproductive health in teenage women orphaned and made vulnerable by AIDS in eastern Zimbabwe.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1153)

Wambe M, Gregson S, Nyamukapa CA, Garnett GP, Lewis JJ, Mason PR, Chandiwana SK, Anderson RM
Biomedical Research and Training Institute, Harare, Zimbabwe

BACKGROUND: Orphans and children made vulnerable by HIV/AIDS (OVCs) in sub-Saharan Africa could be at increased risk of HIV infection and other adverse reproductive health outcomes.

METHODS: Data on HIV infection, sexually transmitted infection (STI) symptoms, and pregnancy, and common risk factors were collected for OVCs and non-OVCs in a large population survey in Eastern Zimbabwe between July 2001 and March 2003. Multivariate logistic regression models were developed to test for statistical associations between OVC status, adverse reproductive health outcomes, and suspected risk factors.

RESULTS: Amongst women aged 15-18 years, OVC status was associated with increased risks of HIV infection (p=0.001), STI symptoms (adjusted OR 2.14; [95% CI, 0.99-4.60]) and pregnancy (adjusted OR 3.70; [95% CI, 1.51-9.09]). Maternal death and having an HIV-positive parent but not paternal death increased adverse reproductive outcomes. Curtailed schooling was associated with early sexual activity and marriage which, in turn, were associated with poor reproductive health. OVCs (overall), maternal orphans and young women with an infected parent were more likely to have received no secondary school education and to have started sex. OVC status was not associated with HIV infection (p=1.000) or STI symptoms (p=0.447) in men aged 17-18 years.

CONCLUSIONS: Maternal orphanhood and parental HIV infection account for substantial proportions of HIV infections, other STIs and pregnancies among teenage girls in eastern Zimbabwe. Substantial further increases in maternal orphanhood are projected and could hamper efforts to slow the spread of HIV to successive generations of young adults.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, Reproductive Medicine, Africa South of the Sahara, Risk Factors, HIV Seropositivity, Sexual Behavior, Demography, Zimbabwe, Poverty, Maternal Mortality, Adolescent, Humans, Female, Male, Adult, Child, Pregnancy, Adolescence

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TuOrC1153