{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T07:27:41Z","timestamp":1776929261634,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T00:00:00Z","timestamp":1679097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Sub\u2010Saharan African countries have the highest perinatal mortality rates. Although HIV is a risk factor for perinatal death, antioretroviral therapy (ART) programs have been associated with better outcomes. We aimed to investigate how maternal HIV affects perinatal mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors performed a nested case\u2013control study at Saint Luke Hospital, Wolisso, Ethiopia. Data on sociodemographic characteristics, current maternal conditions, obstetric history, and antenatal care (ANC) services utilization were collected. The association between perinatal mortality and HIV was assessed with logistic regression adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3525 birthing women were enrolled, including 1175 cases and 2350 controls. Perinatal mortality was lower among HIV\u2010positive women (18.3% vs. 33.6%, <jats:italic>P<\/jats:italic>\u00a0=\u20090.007). Crude analysis showed a protective effect of HIV (odds ratio, 0.442 [95% confidence interval, 0.241\u20130.810]), which remained after adjustment (adjusted odds ratio, 0.483 [95% confidence interval, 0.246\u20130.947]). Among HIV\u2010negative women, access to ANC for women from rural areas was almost half (18.8% vs. 36.2%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), whereas in HIV\u2010positive women, no differences were noted (<jats:italic>P<\/jats:italic>\u00a0=\u20090.795).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among HIV\u2010positive mothers, perinatal mortality was halved and differences in access to ANC services by area were eliminated. These data highlight the benefits of integrating ANC and HIV services in promoting access to the health care system, reducing inequalities and improving neonatal mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14738","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T13:59:52Z","timestamp":1677160792000},"page":"759-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The <scp>HIV<\/scp> paradox: Perinatal mortality is lower in <scp>HIV<\/scp>\u2010positive mothers\u2014A field case\u2013control study in Ethiopia"],"prefix":"10.1002","volume":"162","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9561-0711","authenticated-orcid":false,"given":"M.","family":"Fonzo","sequence":"first","affiliation":[{"name":"Hygiene and Public Health Unit, DCTVSP University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. 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