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PLOS ONE  2014 

Lifetime Induced Abortion: A Comparison between Women Living and Not Living with HIV

DOI: 10.1371/journal.pone.0095570

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Abstract:

Background 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. Methods Data 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. Findings The 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. Conclusion Although 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.

References

[1]  Alan Guttmacher Institute (2008) Facts on Induced Abortion Worldwide. New York: Allan Guttmacher Institute. pp. 2.
[2]  Sedgh G, Singh S, Shah IH, Ahman E, Henshaw SK, et al. (2012) Induced abortion: incidence and trends worldwide from 1995 to 2008. Lancet doi: 10.1016/s0140-6736(11)61786-8
[3]  Brazil (1940) Decree-Law No. 2.848, of December 7, 1940. Brasília: Presidency of Republic.
[4]  Zordo S (2012) Representa??es e experiências sobre aborto legal e ilegal dos ginecologistas-obstetras trabalhando em dois hospitais maternidade de Salvador da Bahia. Cien Saude Colet 17: 1745–1754. doi: 10.1590/s1413-81232012000700013
[5]  Souza e Silva R, Fusco CLB (2009) [Aborto provocado: uma ilegal realidade]. In: Miranda-Ribeiro P, Sim?o AB, editors. [Characterizing the numbers: studies on sexual and reproductive health in Brazil]. 2 ed. Belo Horizonte: ABEP: UNFPA. pp. 452.
[6]  Monteiro MFG, Adesse L (2006) [Estimates of induced abortion in Brazil and Major Regions (1992–2005)]. [Proceedings of the XV National Meeting of Population Studies (ABEP)]. Caxambu - MG 1–10.
[7]  Diniz D, Medeiros M (2010) [Abortion in Brazil: a household survey using the ballot box technique]. Cien Saude Colet 15 Suppl 1: 959–966.
[8]  World Health Organization (2011) Global HIV/AIDS response: epidemic update and health sector progress towards universal access. Geneva: WHO. pp. 229.
[9]  Brasil (2012) [HIV/Aids in Brazil] - 2012. In: Departament of HIV, Aids and Viral Hepatitis, Secretary of Health Surveillance, Ministry of Health, editors. Brasília: Ministério da Saúde.
[10]  Brazil. Ministry of Health (2011) Casos de Aids identificados no Rio Grande do Sul: frequencia por faixa etaria e sexo.
[11]  Bui KC, Gammeltoft T, Nguyen TT, Rasch V (2010) Induced abortion among HIV-positive women in Quang Ninh and Hai Phong, Vietnam. Trop Med Int Health 15: 1172–1178. doi: 10.1111/j.1365-3156.2010.02604.x
[12]  Hankins C, Tran T, Lapointe N (1998) Sexual behavior and pregnancy outcome in HIV-infected women. Canadian Women's HIV Study Group. J Acquir Immune Defic Syndr Hum Retrovirol 18: 479–487. doi: 10.1097/00042560-199808150-00010
[13]  Johnstone FD, Brettle RP, MacCallum LR, Mok J, Peutherer JF, et al. (1990) Women's knowledge of their HIV antibody state: its effect on their decision whether to continue the pregnancy. BMJ 300: 23–24. doi: 10.1136/bmj.300.6716.23
[14]  Thackway SV, Furner V, Mijch A, Cooper DA, Holland D, et al. (1997) Fertility and reproductive choice in women with HIV-1 infection. AIDS 11: 663–667. doi: 10.1097/00002030-199705000-00014
[15]  Barbosa RM, Pinho A, Santos NS, Filipe E, Villela W, et al. (2009) [Induced abortion in women of reproductive age living with and without HIV/Aids in Brazil]. Cien Saude Colet 14: 1085–1099.
[16]  Abigail W, Power C (2008) A systematic review of trend studies of women seeking termination of pregnancy. J Clin Nurs 17: 2951–2962. doi: 10.1111/j.1365-2702.2008.02406.x
[17]  Shah I, Ahman E (2004) Age Patterns of Unsafe Abortion in Developing Country Regions. Reprod Health Matters 9–17. doi: 10.1016/s0968-8080(04)24002-2
[18]  Edmeades J, Lee-Rife SM, Malhotra A (2010) Women and reproductive control: the nexus between abortion and contraceptive use in Madhya Pradesh, India. Stud fam plann 41: 75–88. doi: 10.1111/j.1728-4465.2010.00228.x
[19]  Center for Disease Control and Prevention (2011) Abortion Surveillance — United States, 2008. Atlanta: Center for Disease Control and Prevention,.
[20]  Sihvo S, Bajos N, Ducot B, Kaminski M (2003) Women's life cycle and abortion decision in unintended pregnancies. J Epidemiol Community Health 57: 601–605. doi: 10.1136/jech.57.8.601
[21]  Barrett G, Peacock J, Victor CR (1998) Are women who have abortions different from those who do not? A secondary analysis of the 1990 national survey of sexual attitudes and lifestyles. Public health 112: 157–163. doi: 10.1038/sj.ph.1900453
[22]  Lee E, Clements S, Ingham R, Stone N (2004) A matter of choice? Explaining national variation in teenage abortion and motherhood. York: University of Southampton.
[23]  Rede Feminista de Saúde (2005) [Dossier Abortion: Preventable and Avoidable Deaths]. Belo Horizonte: Rede Feminista de Saúde. 48 p.
[24]  Bankole A, Singh S, Haas T (1998) Reasons Why Women Have Induced Abortions: Evidence from 27 Countries. Int Fam Plan Perspect 24: 117–152. doi: 10.2307/3038208
[25]  Tornbom M, Ingelhammar E, Lilja H, Svanberg B, Moller A (1999) Decision-making about unwanted pregnancy. Acta Obstet Gynecol Scand 78: 636–641. doi: 10.1080/j.1600-0412.1999.780713.x
[26]  Kroelinger CD, Oths KS (2000) Partner support and pregnancy wantedness. Birth 27: 112–119. doi: 10.1046/j.1523-536x.2000.00112.x
[27]  Zabin LS, Huggins GR, Emerson MR, Cullins VE (2000) Partner effects on a woman's intention to conceive: ‘not with this partner’. Fam Plann Perspect 32: 39–45. doi: 10.2307/2648147
[28]  Fischer RC, Stanford JB, Jameson P, DeWitt MJ (1999) Exploring the concepts of intended, planned, and wanted pregnancy. J Fam Pract 48: 117–122.
[29]  Santelli JS, Speizer IS, Avery A, Kendall C (2006) An exploration of the dimensions of pregnancy intentions among women choosing to terminate pregnancy or to initiate prenatal care in New Orleans, Louisiana. Am J Public Health 96: 2009–2015. doi: 10.2105/ajph.2005.064584
[30]  Martino SC, Collins RL, Ellickson PL, Klein DJ (2006) Exploring the link between substance abuse and abortion: the roles of unconventionality and unplanned pregnancy. Perspect Sex Reprod Health 38: 66–75. doi: 10.1363/3806606
[31]  Coleman PK, Reardon DC, Rue VM, Cougle J (2002) A history of induced abortion in relation to substance use during subsequent pregnancies carried to term. Am J Obstet Gynecol 187: 1673–1678. doi: 10.1067/mob.2002.127602
[32]  Boisson EV, Rodrigues LC (2002) Factors associated with HIV infection are not the same for all women. J Epidemiol Community Health 56: 103–108. doi: 10.1136/jech.56.2.103
[33]  Bongain A, Berrebi A, Marine-Barjoan E, Dunais B, Thene M, et al. (2002) Changing trends in pregnancy outcome among HIV-infected women between 1985 and 1997 in two southern French university hospitals. Eur J Obstet Gynecol Reprod Biol 104: 124–128. doi: 10.1016/s0301-2115(02)00103-3
[34]  van Benthem BH, de Vincenzi I, Delmas MC, Larsen C, van den Hoek A, et al. (2000) Pregnancies before and after HIV diagnosis in a european cohort of HIV-infected women. European Study on the Natural History of HIV Infection in Women. AIDS 14: 2171–2178. doi: 10.1097/00002030-200009290-00014
[35]  Kline A, Strickler J, Kempf J (1995) Factors associated with pregnancy and pregnancy resolution in HIV seropositive women. Soc Sci Med 40: 1539–1547. doi: 10.1016/0277-9536(94)00280-7
[36]  Barbosa RM, Pinho AA, Santos NS, Villela WV (2012) Exploring the relationship between induced abortion and HIV infection in Brazil. Reprod Health Matters 20: 80–89. doi: 10.1016/s0968-8080(12)39633-x
[37]  Villela WV, Barbosa RM, Portella AP, de Oliveira LA (2012) [Motives and circumstances surrounding induced abortion among women living with HIV in Brazil]. Cien Saude Colet 17: 1709–1719.
[38]  Friedman RK, Bastos FI, Leite IC, Veloso VG, Moreira RI, et al. (2011) Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil. Rev Saude Publica 45: 373–381. doi: 10.1590/s0034-89102011000200016
[39]  Bajos N, Lamarche-Vadel A, Gilbert F, Ferrand M (2006) Group C, (2006) et al. Contraception at the time of abortion: high-risk time or high-risk women? Human reproduction (Oxford, England) 21: 2862–2867. doi: 10.1093/humrep/del268
[40]  SAS Institute Inc. (2011) SAS/STAT? 9.3 User's Guide. Cary, NC: SAS Institute Inc. 8640 p.
[41]  Hanley JA, Negassa A, Edwardes MD, Forrester JE (2003) Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol 157: 364–375. doi: 10.1093/aje/kwf215
[42]  Bruyn M (2005) HIV/AIDS and reproductive health: Sensitive and neglected issues; Ipas, editor. Chapel Hill. 95 p.
[43]  Osis MJ, Hardy E, Faundes A, Rodrigues T (1996) [Difficulties encountered in gathering information on illegal abortion in the population of women]. Rev Saude Publica 30: 444–451.
[44]  Rossier C (2003) Estimating induced abortion rates: a review. Stud Fam Plann 34: 87–102. doi: 10.1111/j.1728-4465.2003.00087.x
[45]  Knauth DR (1997) [Materhood under the sign of AIDS: a study of infected women]. In: Costa AO, editor. Late Rights: health, sexuality and reproduction in Latin America]. S?o Paulo: Editora 34. pp. 39–64.
[46]  Mann JM (1992) AIDS in the World; Mann JM, Tarantola D, Netter TW, editors. Cambridge, Massachusetts: Harvard University Press.
[47]  Brazil (1996) Law n. 9,263, January 12th 1996. In: Republic Pot, editor. Brasília.
[48]  Coelho EAC, Lucena MFG, Silva ATM (2000) [Family planning in Brazil in the context of public health policies: important historical factors]. Rev Esc Enferm USP 34: 37–44.
[49]  United Nations Population Fund (2008) [Family Planning in Brazil: 50 years of History]. 44.
[50]  Brazil (2009) [National Demographic and Health Survey of Children and Women - PNDS 2006: dimensions of the reproductive process and child health]. Brasília: Ministry of Health, Brazilian Center for Analysis and Planning. 300 p.
[51]  Lacerda MA, Miranda-Ribeiro P, Caetano AJ, Machado CJ (2005) Measurement and profiles of unsatisfied demands for contraceptives in the municipalities of Belo Horizonte and Recife, Brazil, 2002. R bras Est Pop 22: 113–129.
[52]  Bajos N, Moreau C, Leridon H, Ferrand M (2004) Why has the number of abortions not declined in France over the past 30 years?. Population and Society 407: 1–4.
[53]  Brazil (2004) [National policy of comprehensive care to women's health: principles and guidelines]. In: Actions. Ministry of Health. Department of Health Care. Department of Strategic Programmatic Actions, editors. Brasília: Ministry of Health. pp. 82.
[54]  Brazil (1999) [National STD/Aids Policy: principles and guidelines]. In: Coordination National STD and Aids Coordination, editor. 1 ed. Brasília: Ministry of Health. pp. 90.

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