Post-diagnosis abortion in women living with HIV/Aids in the south of Brazil

Abstract

Objective: To understand how the HIV diagnosis combines with other factors that influence the decision to abort.Methodology: Data were collected during a crossover study of women aged between 18 and 49 years old and seen in public health services in Porto Alegre, Brazil. The life stories of 18 interviewees who had post-diagnosis abortion were reconstructed on a timeline, using information collected quantitatively.Results: The time between the diagnosis and abortion was 2 years or less for more than half of the women. For some, post-diagnosis abortion did not mean the end of reproductive life. The most frequent reason for terminating pregnancy was to be living with HIV; however, only some of the women who stated having this motivation did not have post-diagnosis children. Changing partners between pregnancies was a recurring finding; however, in most pregnancies that ended in abortion, the women lived with their partners.Discussion: The analysis of the reproductive trajectory of the women studied showed that there is no specific profile of the woman who aborts after receiving the HIV diagnosis. Although this diagnosis may be involved in the decision to terminate a pregnancy, it does not necessarily result in the end of a woman's reproductive trajectory. Thus, abortion should be understood within a diversity of decision-making processes and the specific moment of a woman's life story.

A retrospective study on adverse obstetric outcomes in HIV-infected pregnancy in West Bengal, India

“…The literature on post-diagnosis abortion is quite limited [2], but indicates that the risk of transmission of the virus to the fetus was one of the factors that weighed on reproductive decisions. The introduction of the protocol for prevention of mother-to-child transmission (PMTCT) has produced a decrease in the rate of pregnancies ended in induced abortion [3].…”

Abortion among women living with or not living with HIV/AIDS users of public health services in São Paulo municipality: prevalence, contexts and reasons

“…19 Having a stable partner or being married with the pregnancy partner seems to be fundamental for the maintenance or interruption of pregnancy, as also show other studies. [20][21][22] If, on the one hand, the conjugality situation is important in the decision to abort, to a significant number of women this decision does not require the partner's knowledge and participation. In a smaller number, abortion situations in which the partner let the woman decide by herself may reflect both respect to the women's decision and non-responsibility in the decision making process.…”

“…In addition, for an expressive number of WLHA, HIV was of little importance in the decision for abortion, suggesting that other life situations had a greater weight. In the trajectory analysis of 18 women who aborted after diagnosis, Pilleco et al 21 observed that HIV was referred as the main reason for aborting. Nevertheless, other adverse situations influenced the decision, as the lack of financial conditions, woman's or partner's unwillingness to have more children and the relationship situation with the partner, reasons similar to those found in the present paper.…”

Trajetórias de mulheres vivendo com HIV/aids no Brasil. Avanços e permanências da resposta à epidemia

“…Nesta direção, estudos realizados no início dos anos 2000 já haviam indicado que a intenção de ter filhos entre mulheres vivendo com HIV estava mais influenciada pelo tamanho de suas famílias do que pelo diagnóstico 11 . Pesquisas mais recentes, apontam que a indução do aborto entre mulheres vivendo com HIV/aids no Rio Grande do Sul deve ser interpretada à luz das suas trajetórias reprodutivas, e não apenas da infecção pelo HIV 12,13 , confirmando achados de estudos anteriores 14 . A utilização da perspectiva das trajetórias também foi utilizada para analisar os recursos e as estratégias de enfrentamento do estigma entre gestantes vivendo com HIV/aids no Rio de Janeiro 15 .…”