Laboratório de Pesquisa Clínica em DST/AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
HIV Res Clin Pract. 2024 Dec;25(1):2401268. doi: 10.1080/25787489.2024.2401268. Epub 2024 Sep 10.
Abortion is a public health problem in Latin America and is more common among women living with HIV.
to verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil.
Prospective cohort during the period 1996-2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome "induced abortion" using a generalized linear mixed model.
753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10-0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02-0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02-0.70).
We showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.
在拉丁美洲，堕胎是一个公共卫生问题，在感染艾滋病毒的女性中更为常见。
在巴西里约热内卢的一个艾滋病毒感染者护理服务参考机构中，调查感染艾滋病毒的女性队列中人工流产的发生率和相关因素。
前瞻性队列研究，时间为 1996 年至 2016 年。通过计算随访期间队列中人工流产的人数时间发生率[每 100 人年（PY）]来估计队列中人工流产的发生率，并使用广义线性混合模型来研究与结局“人工流产”相关的因素。
本研究共纳入 753 名女性和 210 次妊娠。研究期间，我们估计人工流产发生率为 0.68/100 人年（95%可信区间[CI]：0.47；0.94），2006 年后显著下降。与人工流产相关的主要因素是目前与伴侣生活在一起（调整后的比值比[AdjOR]0.32，95%CI：0.10-0.98）、子女数量（有 2 个子女的 AdjOR0.12，95%CI：0.02-0.95）和所使用的抗逆转录病毒治疗类型（不含依非韦伦的方案：AdjOR：0.11，95%CI 0.02-0.70）。
我们显示，巴西里约热内卢感染艾滋病毒的女性队列中人工流产的发生率显著下降，这可能是由于同期观察到的妊娠发生率下降所致。与人工流产发生率较低相关的因素表明，为这些女性提供的临床和生殖援助之间有很好的整合。
