Abstract
BackgroundStudies aimed at understanding the association between induced abortion and HIV are scarce and differ on the direction of the association. This paper aims to show the prevalence of induced abortion in a sample of pregnancies of women living and not living with HIV/Aids, determining variables associated with pregnancy termination and linked to the life course of women and to the specific context of the pregnancy.MethodsData came from a cross-sectional study, using interviewer-administered questionnaire, developed with women that attended public health services in Porto Alegre, Brazil. A generalized estimating equation model with logit link measured the association between determinants and abortion.FindingsThe final sample was composed of 684 women living with HIV/Aids (2,039 pregnancies) and 639 women not living with HIV/Aids (1,539 pregnancies). The prevalence of induced abortion among pregnancies in women living with HIV/Aids was 6.5%, while in women not living with HIV/Aids was 2.9%. Among women living with HIV/Aids, the following were associated with induced abortion in the multivariable analysis: being older, having a higher education level, having had more sexual partners (i.e., variables linked to the life course of women), having had children prior to the index pregnancy and living with a sexual partner during pregnancy (i.e., variables linked to the context of each pregnancy). On the other hand, among women not living with HIV/Aids, only having a higher education level and having had more sexual partners (i.e., determinants linked to the life course of women) were associated with voluntary pregnancy termination in multivariable analysis.ConclusionAlthough determinants are similar between women living and not living with HIV/Aids, prevalence of induced abortion is higher among pregnancies in women living with HIV/Aids, pointing to their greater social vulnerability and to the need for public policy to address prevention and treatment of HIV associated with reproductive issues.
Highlights
Of the 210 million pregnancies that occurred worldwide in 2008, 16% resulted in unplanned births and 21% in induced abortion [1,2].In Brazil, as in most Latin American countries, induced abortion is classified as a crime against life, being allowed only in cases of rape, risk to the woman’s life or an anencephalic fetus [3,4]
This paper aims to show the prevalence of induced abortion in all pregnancies of a WLHA group and a WNLHA group that attended public health services in Porto Alegre, Brazil, determining variables associated with pregnancy termination and linked both to the life course of women and to the specific context of the pregnancy
Of the 1,241 pregnancies that occurred in WNLHA 2.9% (36 pregnancies) ended in induced abortion
Summary
Of the 210 million pregnancies that occurred worldwide in 2008, 16% resulted in unplanned births and 21% in induced abortion [1,2].In Brazil, as in most Latin American countries, induced abortion is classified as a crime against life, being allowed only in cases of rape, risk to the woman’s life or an anencephalic fetus [3,4]. Of the 210 million pregnancies that occurred worldwide in 2008, 16% resulted in unplanned births and 21% in induced abortion [1,2]. The rate was 2.07 abortions per 100 women aged between 15 and 49, and the estimated number of abortions accounted for 30% of live births [6]. Studies aimed at understanding the association between induced abortion and HIV are scarce and differ on the direction of the association. This paper aims to show the prevalence of induced abortion in a sample of pregnancies of women living and not living with HIV/Aids, determining variables associated with pregnancy termination and linked to the life course of women and to the specific context of the pregnancy
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