Effect of HIV and Substance Use Comorbidity on the Placenta and Maternal Outcomes (R01 Clinical Trial Optional)

Human immunodeficiency virus (HIV) infection is widely prevalent in individuals in the reproductive age group. Globally, an estimated 1.3 million people living with HIV (PWH) become pregnant each year (UNAIDS data, 2019). With the advent of antiretroviral therapy (ART), significant progress has been made in the prevention of vertical transmission of HIV. However, although ART has clear benefits in preventing vertical transmission, ART regimens are associated with higher rates of preterm birth, stillbirth, and early infant death. Optimal development and functioning of the placenta are key factors in maintenance of pregnancy and positively corelate with maternal and fetal outcomes. Despite this, there is considerable paucity of data on the impact of HIV/ART exposure on the placenta. Even less is known on the impact of HIV/ART exposure on the placenta in pregnant individuals with substance use/misuse.