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A higher risk of anemia in WLHIV could partially explain this disparity. Using a birth outcomes surveillance study in Botswana, we emulated target trials corresponding to currently available or feasible interventions on anemia. The first target trial evaluated 2 interventions: initiate multiple micronutrient supplementation (MMS), and MMS or iron and folic acid supplementation by 24\u00a0weeks gestation. The remaining target trials evaluated the interventions: eliminate anemia before pregnancy; and jointly eliminate anemia before pregnancy and initiate MMS. We estimated the observed disparity in adverse birth outcomes between WLHIV and WWHIV and compared the observed disparity measure (ODM) to the counterfactual disparity measure (CDM) under each intervention. Of 137\u2009499 individuals (22% WLHIV), the observed risk of any adverse birth outcome was 26.0% in WWHIV and 34.5% in WLHIV (ODM, 8.5%; 95% confidence interval [CI], 7.9-9.1%). Counterfactual disparity measures (95% CIs) ranged from 6.6% (4.8-8.4%) for the intervention to eliminate anemia and initiate MMS to 8.4% (7.7%-9.1%) for the intervention to eliminate anemia only. Preventing anemia and expanding MMS may reduce HIV disparities in birth outcomes, but interventions with greater impact should be identified.<\/jats:p>","DOI":"10.1093\/aje\/kwae160","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T21:17:15Z","timestamp":1720041435000},"page":"122-131","source":"Crossref","is-referenced-by-count":2,"title":["How much could anemia-related interventions reduce the HIV disparity in adverse birth outcomes?"],"prefix":"10.1093","volume":"194","author":[{"given":"Ellen C","family":"Caniglia","sequence":"first","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine Department of Biostatistics, Epidemiology, and Informatics, , Philadelphia, USA"},{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Zash","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"},{"name":"Beth Israel Deaconess Medical Center Infectious Disease, , Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Modiegi","family":"Diseko","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Mayondi","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Mabuta","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mompati","family":"Mmalane","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Makhema","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise L","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M","family":"Bengtson","sequence":"additional","affiliation":[{"name":"Emory University School of Public Health Department of Epidemiology, , Atlanta, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Lockman","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"},{"name":"Harvard T.H. Chan School of Public Health , Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership , Gaborone, Botswana"},{"name":"Harvard T.H. 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