The significant correlates of unintended pregnancy after HIV diagnosis in our multivariable model were never being married and having given birth to no more than one child. No other studies that we identified assessed correlates of unintended pregnancies in HIV-positive women. Understanding the sociodemographic correlates of unintended pregnancies is clinically important, allowing clinicians to target HIV-positive women at higher risk of unintended pregnancies. There were additional clinically significant sociodemographic correlates of unintended pregnancies

that Ontario clinicians may want to consider that lacked statistical significance because of a lack of power, including ethnic background, years in Canada, education level, HIV risk factor, and HBV or HCV coinfection. However, we assert that pregnancy planning, family planning and contraception discussion should be part of the standard discussion with VX-809 mw all HIV-positive women and probably also men. For all women, HIV-infected or not, unintended pregnancies are associated with increased risks of poor maternal and fetal outcomes and this is reason enough to discuss family and pregnancy DAPT planning [19]. In the setting of HIV care, it is imperative that issues related to antiretroviral and other drugs that could be teratogenic and the risk

of horizontal transmission to an uninfected sexual partner are discussed, considering the high rate of unintended pregnancies in this population [20]. Current therapeutic guidelines for first-line HIV

treatment recommend use of tenofovir, emtricitabine and efavirenz, which are co-formulated in a single pill taken once daily (Atripla®; Gilead Sciences Inc, Foster City, CA, USA) [21]. Although other first-line HIV treatment options are available, Atripla® is a popular regimen because of its low pill burden. However, efavirenz is known to be teratogenic, emphasizing the need to discuss pregnancy intentions and contraception as well as alternative treatment options with HIV-positive women of reproductive Ribonucleotide reductase age who are considering HIV treatment. Reducing the occurrence of unintended pregnancies among HIV-positive women may also reduce the occurrence of VPT. A recent Italian study compared 63 cases of VPT with 334 pregnancies not ending in a VPT among HIV-positive women. The authors found a significant correlation between unintended pregnancy and VPT (odds ratio 24.3; 95% CI 5.8–101.2), leading them to conclude that improved access to pregnancy planning in the context of HIV infection could reduce the occurrence of VPT. We also found a high rate of VPT in our cohort, with 47% reporting having had a VPT at some time in their life. A landmark piece by Wilcher and Cates [23] about reproductive choices for women living with HIV was recently published in the WHO Bulletin.