Do women with complications of an incomplete abortion have different HIV infection status than women without complications?

Abstract

Purpose: Little is known about the status of HIV among women who have had abortions and even less about women who have suffered from abortion complications. Understanding this connection is critical for building the evidence base and for guiding strategies to manage the sexual and reproductive health needs of women living with HIV. The purpose of this research is to assess if HIV infection status differed between women who suffered incomplete abortion complications and those who visited the hospital for other obstetric needs. Methods: The analysis used a secondary data set from a published case-control study that enrolled 1) women at discharge after receiving in-patient care for complications resulting from induced abortion, and 2) women (the comparison group) who visited the same hospital during the same time period for other obstetric needs. Unadjusted and adjusted associations between being in the abortion complications group, HIV status and other selected population characteristics were estimated using univariate and multivariate logistic regression. Results: Compared to women who were HIV negative, women who were HIV positive had similar odds of being in the abortion complications group in both univariate and multivariate analyses (ρ =0.62 and ρ = 0.76). However, compared to HIV-negative women, those women who did not know their HIV status had greater odds of being in the abortion complications group (OR=3.8, 95% CI, 1.88, 8.20) in univariate analysis. After adjusting for potential confounding variables, the odds of being in the abortion complications group remained greater among women who did not know their HIV status compared to HIV-negative women (adjusted OR = 2.8, 95% CI, 1.20, 6.54). Conclusions: Compared to HIV-negative women, HIV-positive women had similar odds of being in the abortion complications group. However, not knowing one's HIV status resulted in approximately three-fold higher odds of being in the abortion complications group compared to being HIV negative, pointing to the need for targeted interventions aimed at strengthening the delivery and coverage of HIV-testing programs for pregnant women and post-abortion care. In addition, further research examining the linkages between HIV and reproductive health is strongly recommended.