Abeni D D, Porta D, Perucci C A
Epidemiology Unit, Lazio Region Health Authority, Rome, Italy.
Eur J Epidemiol. 1997 Jun;13(4):373-8. doi: 10.1023/a:1007348616909.
The prevalence of HIV-1 among women of reproductive age is currently estimated at the time they give birth. We assessed HIV-1 prevalence at the end of pregnancy, whether they delivered or had an induced or spontaneous abortion. Women admitted at the end of pregnancy to hospitals in the Lazio Region, Italy, were tested for antibodies to HIV-1. Consent for testing was granted by 97.1% of 218,357 subjects; women who did not consent were tested anonymously. The prevalences of infection were 0.34% in 1989, 0.38% in 1990, 0.28% in 1991, 0.23% in 1992, 0.28% in 1993, and 0.24% in 1994. Significantly higher prevalences of infection were associated with induced abortion (0.49%) than with delivery (0.18%; OR: 2.72; 95% CI: 2.29-3.22) and among women who refused (0.85%) than among those who consented to testing (0.27%; OR: 3.14; 95% CI: 2.35-4.19). A significant temporal reduction in prevalence was observed only among women who delivered (0.15% in 1993 and 1994; 0.26% in 1989 and 1990). The prevalence of HIV-1 infection is thus higher among women undergoing induced abortions than among those who deliver and higher among women who refuse testing than among those who consent. Studies confined to neonatal testing or to voluntary testing of pregnant women would thus underestimate the prevalence of HIV-1 among women of reproductive age.
目前对育龄女性感染HIV-1的患病率估计是在她们分娩时进行的。我们评估了妊娠末期（无论其是分娩、人工流产还是自然流产）的HIV-1患病率。意大利拉齐奥地区医院收治的妊娠末期女性接受了HIV-1抗体检测。218357名受试者中97.1%同意检测；不同意的女性进行了匿名检测。1989年感染率为0.34%，1990年为0.38%，1991年为0.28%，1992年为0.23%，1993年为0.28%，1994年为0.24%。与分娩（0.18%；比值比：2.72；95%可信区间：2.29 - 3.22）相比，人工流产女性的感染率（0.49%）显著更高；与同意检测的女性（0.27%；比值比：3.14；95%可信区间：2.35 - 4.19）相比，拒绝检测的女性（0.85%）感染率显著更高。仅在分娩女性中观察到患病率随时间显著下降（1993年和1994年为0.15%；1989年和1990年为0.26%）。因此，接受人工流产的女性中HIV-1感染率高于分娩女性，拒绝检测的女性中感染率高于同意检测的女性。局限于新生儿检测或孕妇自愿检测的研究因此会低估育龄女性中HIV-1的患病率。
