Fertility rates in 238 HIV-1-seropositive women in Zaire followed for 3 years post-partum

Birth control use and fertility rates were determined prospectively in 238 HIV-1-seropositive and 315 HIV-1-seronegative women in Kinshasa Zaire during the 36 month period following the delivery of their last liveborn child. No women delivered children during the 1st followup year. Birth control utilization rates (% use during total observation time) and fertility rates (annual number of livebirths/1000 women of childbearing age) in the 2nd year of followup were 19% (107.4/1000 for HIV-1-seropositive women and 16% (144.7/1000) for HIV-1-seronegative women. In the 3rd year of followup these rates were 26 (271.0/1000) and 16% (38.6/1000) for HIV-1-seropositive and HIV-1-seronegative women respectively (p<0.05 for the difference in birth control usage and fertility rates between seropositive and seronegative women in the 3rd year of followup). 7 (2.9%) of the 238 HIV-1-seropositive women initially included in the study brought their sex partners in for HIV-1 testing; 3 (43%) of these men were found to be HIV-1-seropositive. New HIV-1 infection did not have a dramatic effect on the fertility of seropositive women. The almost unanimous unwillingness of HIV-1-seropositive women to inform husbands or sexual partners of their HIV-1 serostatus accounted in large part for the disappointingly high fertility rates in seropositive women who had been provided with a comprehensive program of HIV counseling and birth control. Counseling services for seropositive women of childbearing age which do not also include the sexual partners of these women are unlikely to effect any impact on their high fertility rates. (authors)