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Women with HIV and the decision of having an abortion

Research investigates how the interruption of pregnancy is inserted in HIV/AIDS women's life
Women with HIV and the decision of having an abortion

Having safe abortion is one of feminist movement demands around the globe - Photo: Thercles Silva/Flickr

According to Epidemiological Bulletin of the Ministry of Health, since the beginning of the AIDS epidemic in Brazil (1980), 491,747 (65%) cases of Aids in men were registered, and 265,251 (35%) in women. Although the disease is more prevalent in men than women, the difference has oscillated over the years. Among pregnant women infected with HIV, more than 84,000 have been notified. Most of these women live in the Southeast (41,1%) and in the South (31,1) of Brazil.

Such scenario also raises the question concerning women's reproductive decision: how do women deal with the possibility of having an abortion? Is there a difference in the decision among women who do not live with the virus? That is what the researcher in Public Health Flávia Bulegon Pilecco investigated in her doctoral thesis Abortion in Women with HIV/AIDS.  The thesis was defended at UFRGS Postgraduate Programme in Epidemiology under the supervision of  Professor Daniela Riva Knauth and Professor Álvaro Vigo.

Women between 18 and 49 years old were interviewed in Porto Alegre. Among these women, 684 living with HIV/AIDS and 639 of women living without the disease. Those living with HIV/AIDS were interviewed in health units specialised in the treatment of the disease, and those without were interviewed in Basic Health Units (UBS) in Porto Alegre. According to Pilecco, the epidemiological research was conducted transversally, i.e, an 'immediate' evaluation of health condition. Based on literature, the research shows that there has been a decrease in abortion rate after the introduction of Protocol for PMTCT[1] in 1996. "This protocol substantially reduces the risk of women living with HIV transmit the virus to the fetus", Pilecco explains. This practice decreased from 29,6% in 1990 to 3,4% in 2004 in countries such as the United Kingdom and Ireland.

According to Pilecco, most of the abortions occurred before HIV diagnosis. Therefore, interviewed women living with HIV/AIDS had already sought for a health unit for the abortion. "However, this health units missed a great opportunity to discuss the importance of condoms, as these women were infected with the virus," she states.


Social and economic vulnerability

Even though the research concluded that women with HIV are more at risk of induced abortion than women who are not infected, the decision on having an abortion is the same. Although HIV does impact on the decision of having an abortion, the social and economic vulnerability and the relationship these women have with their partners are the most frequent factors related to the practice. Being in an unstable job, not having social support from their family and/or partner, unstable relationship, an unplanned pregnancy or having suffered physical and sexual abuse are all factors that contribute to the final decision.



Pilecco received a Capes Award for Theses in 2015 in the Public Health category. The researcher had been interested in the subject since her undergraduate course in Biomedicine and she faced difficulties in the bibliography because abortion is illegal in Brazil. "There is much more difficulty in obtaining data about the practice of abortion. But even in countries in which abortion is legal the studies show underreporting. There are no official data concerning the subject in Brazil, the result is that we start from the assumption that our data is underestimated", she says. When asked about a position in favour of abortion legalisation, Pilecco points out that "the research defends that access to legal and safe abortion is a woman's health right".


Thesis title: Abortion caused by women with HIV/AIDS
Author: Flávia Bulegon Pilecco
Supervisor: Daniela Riva Knauth
Co-supervisor: Álvaro Vigo
Unit: Postgraduate Programme in Epidemiology

Portuguese version available at:


Translated by Joana Souza under the supervision of Professor Márcia Moura da Silva (UFRGS)

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