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Sexual and reproductive health needs for young women living with perinatally acquired HIV through the pandemic
HIV Medicine ; 22(SUPPL 2):114, 2021.
Article in English | EMBASE | ID: covidwho-1409355
ABSTRACT

Background:

Lockdown and reconfiguration of NHS services imposed to limit the spread of SARS-CoV- 2 led to significantly reduced uptake of routine NHS care including access to cervical screening, contraceptive and sexual health services. We describe female sexual and reproductive health of a cohort of young women living with perinatally acquired HIV (YWLPaHIV) over the time-period covering SARS-CoV- 2 restrictions.

Method:

Single-centre observational cohort review of sexual and reproductive health for YWLPaHIV attending HIV services 01.07.2020 to 01.01.2021. Data collected included demographics, age of menarche/coitarche, Human papillomavirus (HPV) and Hepatitis B virus (HBV) vaccination, contraception, past sexually transmitted infections (STIs), cervical screening and obstetric history. Analysis was descriptive, with categorical analysis of qualitative data. Primary aim was to identify individuals in need of contraception, cervical screening and HBV vaccination/boosting.

Results:

71 YWLPaHIV median age 23 years (IQR 21-27), 87% of black ethnicity, average body mass index 25.9kg/m2 (SD 5.6) with 58/71 (82%) latest viral load <200 copies/ml. Median age at menarche 13 years (IQR 12-14) with 5/64 (8%) reporting delayed puberty (menarche316 years). 51/71 (72%) reported coitarche, average age 17.6 years. 24 women reported 45 pregnancies;16/45 (36%) live births (all infants HIV-negative), 19(42%) terminations, 7(16%) miscarriages and 3(7%) current pregnancies. Excluding pregnant women;31/48 (65%) reported current contraception;10 (32%) condoms, 8(26%) intrauterine systems, 7(23%) Depo-Provera, 4(13%) implant and 3(10%) oral contraceptive pill. 18/51 (35%) reported previous STIs;HPV (11), chlamydia (9), Herpes Simplex (2). 27/71 (38%) reported ever having a cervical smear including 20/28 (71%) women aged 25 or older, 15(54%) within 3.5 years (national average 69%). Abnormal findings reported in 7/27 (26%) included 5 CIN1 and 3/27 (11%) were HPV positive. 59/71 (83%) recalled prior HPV vaccination. Excluding four YWPaHIV with HBV coinfection, 41/63 (71%) demonstrated HBV surface antibodies >10mIU.

Conclusion:

In this small cohort cervical smear uptake was below the national average despite high levels of previous abnormal findings. Given the high rates of prior STIs and pregnancy terminations, addressing the contraceptive and sexual health needs including vaccination for young women, may require accessible face-2- face services despite the pandemic.

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: HIV Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: HIV Medicine Year: 2021 Document Type: Article