REPRODUCTIVE HEALTH HOSPITALIZATIONS AMONG WOMEN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTIONS

OBJECTIVE: Our goal was to determine types of inpatient admissions amo ng human immunodeficiency virus-infected women both before and after t he human immunodeficiency virus diagnosis, so that we might outline op portunities for intervention. STUDY DESIGN: A total of 292 human immun odeficiency virus-infected women were interviewed about the reproducti ve history and prior hospitalizations. A reproductive health hospitali zation was defined as either an obstetric admission or a gynecologic a dmission. Other admissions were categorized as either human immunodefi ciency virus related, possibly human immunodeficiency virus related, o r not human immunodeficiency virus related. Assignments were made inde pendently by two human immunodeficiency virus specialists, if there wa s a conflict, a third reviewer was used. RESULTS: In the 10 years befo re study entry 44.4% of women had at least one obstetric admission, 30 .4% had at least one gynecologic admission, 3.1% had at least one huma n immunodeficiency virus-related admission, 18.1% had at least one adm ission that was possibly human immunodeficiency virus related, and 13. 3% had at least one admission that was not human immunodeficiency viru s related. Overall, 226 (77%) women had been admitted to the hospital; of these, 201 (69%) had been admitted for reproductive health reasons . Similar patterns were seen in the year before diagnosis and the time after diagnosis. Reproductive health admissions were more common amon g women who were younger, who used drugs, and who had higher CD4(+) ce ll counts. CONCLUSION: Women with human immunodeficiency virus infecti on are often admitted to hospitals for reproductive health reasons bef ore and after the human immunodeficiency virus status is known. Clinic ians providing reproductive health care must be actively engaged in ef forts to reduce the heterosexual and perinatal transmission of human i mmunodeficiency virus, to identify human immunodeficiency virus-infect ed women early in the course of the disease, and to provide ongoing ca re to human immunodeficiency virus-infected women.