Title: The experience of use of medical abortion for HIV-infected women at home in Ukraine
Women with HIV have a right to decide about their reproductive choice. There is no reason why HIV positive women cannot use medical abortion. HIV positive women may be at higher risk of reproductive tract infections from retained products of conception, but this may occur with medical or surgical abortion.
The aim of our study was to assess the efficacy and acceptability of home administration of misoprostol for early medical abortion up to 63 days of amenorrhoea for HIV-infected women.
Methods. This case-control study included 68 cases of medical abortion in HIV-infected women who did not receive antiretroviral therapy. About 20% of women lived in the rural regions. Among of them 10 (14.7%) of women had previous cesarean sections Medical abortion was used the first time in 89.7% of women, the second time – 8.9%, the third time – 1.4%. About 2% of women came back to the hospital after misoprostol because they were worried (25% of them had previous cesarean section).
Results. The method was effective in 95.5% of cases. Three failures (4.5%) were recorded which included incomplete abortion (1.5% of cases), heavy bleeding (1.5% of cases), continuing pregnancy (1.5% of cases). In case of complications we performed vacuum-aspiration. We did not have cases of serious infections after medical abortions. The complete abortion has occurred after taken of misoprostol in the first 3 hours in 46.9% of cases, after 6-9 hours – in 49.4% of women, at the third day – in 2.6% of women and at the fifth day – in 1% of women.
Our study shows very high results of success and minimal complications of medical abortions in HIV-infected women at home (95.5% of cases). More than 80% of women were satisfied. Our data suggest that the use medical abortion at home is the safe effective alternative to surgical abortions for all women.