HOPE

The Health Outcomes around Pregnancy and Exposure to HIV/ARVs (HOPE) explores reproductive health choices, including pregnancy, and overall health outcomes, including reproductive health outcomes. HOPE provides the opportunity to inform future advancements for women living with HIV and their families.

Women living with HIV have unique health experiences, especially during their reproductive years. Improvements in treatment options for HIV have made pregnancy safer, providing more options for these women to start and grow their families. HOPE is a multi-year study of young women of reproductive age living with HIV.

We plan to enroll about 1600 women living with HIV , including about 240 who are living with perinatally acquired HIV. Eligible individuals include women of reproductive age living with HIV who are at least 18 and under 40 years of age:

• Are pregnant or recently delivered; or
• Have never been pregnant; or
• Are not currently pregnant but have children.

The study is designed to evaluate the health outcomes of women living with HIV over time. Women who elect to participate in this study complete a combination of online surveys, clinical assessments, and interviews, with a blood draw and other samples collected at the time a person enrolls into the study.  Information will be taken from a woman’s medical records once a year while she is participating in the HOPE study.  On an annual basis, after enrollment, women will complete an online survey.  

The HOPE study is designed to evaluate:

• Reproductive Health
  Determine factors associated with pregnancy, family planning practices and preferences, and the unique health needs of reproductive-age women living with HIV.
   
• Cardiometabolic Health
  Assess associations of antiretroviral therapy (ART) use with physical health, physical activity, chronic disease, and sleep patterns.
   
• General Health and Co-Infections
  Investigate factors associated with COVID-19 in WLHIV of reproductive age.
   
• HIV Disease, Care Continuum, Care Engagement, and Treatment Adherence
  Explore individual, interpersonal, social and structural determinants of HIV care continuum-related experiences and outcomes.
   
• Substance Use
  Assess the changes in substance use behavior among women living with HIV over time, including the patterns unique to individuals who experience reproductive life events such as pregnancy, the first postpartum year, and early years of parenting. 
   
• Stigma, Racism and Social Determinants of Health
  Assess the relationship of structural racism and individual experiences of racism to the health of women living with HIV.
   
• Mental Health and Psychosocial Conditions
  Explore the unique experiences with mental health among women living with HIV.

To request a copy of the HOPE protocol, please email phacs@hsph.harvard.edu.