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In order to increase the chances of survival and health of children living with HIV infection or other blood infections during pregnancy, there is currently no effective preventative measure, especially when the woman becomes infected during pregnancy, which may be in pregnancy or shortly after delivery.1 The current approach to pregnant women to avoid infection is to refrain from intercourse and avoid sexual intercourse after the child is weaned and before they are old enough to have sexual intercourse. However, even after the child has weaned, the risk of transmission to the fetus increases and can continue for up to 3-4 years postpartum2 and up to 6 years postpartum.1 In addition, this increased risk of transmission to the fetus of the mother who is infected can occur up to 6 years postpartum, although the number of infected pregnant women with postpartum vaginal infection does not increase significantly even after several years.1 Although there is no evidence the use of condoms during and after the pregnancy increases the risk of the transmission of HIV, this risk remains high during periods of sexual activity during the month after pregnancy and up to 5 years after the last sexual intercourse before pregnancy occurred.2,3 Although it is now believed that most maternal infections in children are transmitted through vaginal, not anal, sex,4,5 HIV infection can be transmitted through the anal sex.6 This increased risk of transmission from the anus to the fetus during the first months after delivery is the basis of the recommendation to refrain from sexual intercourse.1,2 However, many women do not adhere to this recommendation, including those who have not recently been infected and have never been sexually active at all. In addition, HIV can be acquired at any age in pregnancy during vaginal intercourse or early after delivery, and transmission increases during the first 3-4 months postpartum7–11 without any restrictions.2,8,12–14
In the present report, we provide the first comprehensive analysis of the association of sexual intercourse up to about 1 year and no-breastfeeding in the first 1 years postpartum as a risk factor for mothers infected with HIV during pregnancy. We aimed to analyze the effect of sexual intercourse and no-breastfeeding during the first 1 years postpartum on the risk of transmission of HIV to the fetus and infant, as well as the association of these variables with the risk of maternal infection, including the presence of active HIV infection.
Methods The present investigation
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