Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2020 Feb 10;36Suppl 1(Suppl 1):e00201318. doi: 10.1590/0102-311X00201318. eCollection 2020.
The aim of this study was to verify the prevalence of induced abortion and associated factors at the time of inclusion in a cohort of women living with HIV/AIDS in the city of Rio de Janeiro, Brazil, from 1996 to 2016. Eligibility criteria for inclusion in the cohort were female sex at birth, age 18 years and older, and confirmed HIV infection. At the baseline visit, data on sexual, reproductive, and behavioral aspects and HIV infection were obtained through a face-to-face interview with the attending physician. Lifetime prevalence of induced abortion was calculated, and factors associated with induced abortion were verified by multiple logistic regression for all the women and for those with previous pregnancy. In the entire cohort of women, 30.4% reported a history of induced abortion, compared to 33.5% in women with previous pregnancy. Frequency of reported induced abortion showed a significant reduction during the period (41.7% in 1996-2000 versus 22.5% in 2011-2016, p < 0.001). Factors associated with induced abortion, both for the entire cohort and for the women with previous pregnancy, were age, schooling, ≥ 5 lifetime sexual partners, teenage pregnancy, lifetime use of any illicit drug, and inclusion in the cohort after the year 2005. Changes in the socioeconomic, sexual, reproductive, and HIV infection profile are possible explanations for the reduction in abortions during the period. Studies that use direct methods to measure abortion should be conducted in other populations to confirm the downward trend in induced abortion and its determinants in Brazil.
本研究旨在验证巴西里约热内卢市 1996 年至 2016 年期间艾滋病毒/艾滋病女性队列中人工流产的流行率及其相关因素。该队列纳入标准为出生时为女性、年龄在 18 岁及以上、并经确认感染 HIV。在基线访视时，通过与主治医生面谈获取性行为、生殖和行为方面以及 HIV 感染方面的数据。通过多因素逻辑回归，计算所有女性和有过妊娠史女性的人工流产终身流行率，并验证与人工流产相关的因素。在整个女性队列中，有 30.4%报告有过人工流产史，而有过妊娠史的女性中这一比例为 33.5%。报告的人工流产频率在研究期间呈显著下降趋势（1996-2000 年为 41.7%，2011-2016 年为 22.5%，p<0.001）。与人工流产相关的因素，无论是在整个队列还是在有过妊娠史的女性中，均为年龄、受教育程度、≥5 个性伴侣、青少年妊娠、终生使用任何非法药物以及 2005 年后入组该队列。社会经济、性行为、生殖和 HIV 感染状况的变化可能是导致该时期人工流产减少的原因。应该在其他人群中开展使用直接方法测量流产的研究，以证实巴西人工流产及其决定因素的下降趋势。
