Fig. 4: Adverse perinatal outcomes attributable to HIV and ARVs in sub-Saharan Africa in 1990–2020.

Numbers of adverse perinatal outcomes attributable to HIV and ARVs annually between 1990 and 2020 (Supplementary Data 1). Pregnant women living with HIV received no ARVs, monotherapy, or cART initiated antenatally or preconception. Perinatal outcomes analysed: preterm birth (a), very preterm birth (b), low birthweight (c), very low birthweight (d), small for gestational age (e), very small for gestational age (f). Note that not all treatment groups of WLHIV had data for all perinatal outcomes and that not all comparisons to HIV-negative women were statistically significant (Fig. 2). Hence, not all categories in the legends (no ARVs, monotherapy, and antenatal and preconception cART) are represented in the graph for each perinatal outcome. Notably, data for very low birthweight and neonatal death was either not available or not statistically significant (Fig. 2a–d). ARVs Antiretroviral drugs, cART Combination antiretroviral therapy, HIV Human immunodeficiency virus.