Surprisingly, an HIV diagnosis during pregnancy did not put women at a significantly higher risk of induced abortion in our cohort. Of note, however, is the finding that fear of vertical transmission in our study was strongly associated with the decision to induce abortion, independently of the time period and the use of cART. Women who were concerned about infecting their child had a twofold increased risk of pregnancy termination. This demonstrates that there is still a need to improve

preconception counselling and to provide HIV-infected women with detailed information about the efficient measures adopted to prevent MTCT. This study has a number of limitations. First, abortion rates were calculated based on events Fluorouracil in vitro that may have occurred some years previously in the personal history of each women, and therefore recall bias cannot be ruled out. Secondly, as abortion rates may differ greatly with respect to population characteristics, such as median age and the prevalence of IDU and of migrant women, caution should be exercised when generalizing

from our results. Thirdly, the DIDI study collected data about condom use and contraception, marital status, spirituality/religiosity and family support, but the information refers to the time at which the questionnaire Selleckchem PFT�� was completed and not the time of the abortion, which might have occurred many years before, and hence their association with induced abortion was not investigated in the present analysis.

The same was true for abortions occurring after HIV diagnosis; parameters related to stage of HSP90 HIV disease were collected from charts at the time of completion of the questionnaire and were not available for the time of the abortion. We assumed that the women’s socioeconomic status would not radically change over time and included it in the analysis; this may possibly have resulted in an underestimation of the number of women in the lower stratum. However, the strengths of our study should also be mentioned: the multicentre nature of the study, the high number of interviewed women living with HIV, and the fact that the outcome was self-reported. Further, our study provides important updated information about abortion rates in HIV-infected women and is the first who formally determine whether there is an interaction between awareness of HIV and calendar period. In conclusion, the high frequency of induced abortion in women who are or will be diagnosed with HIV infection underlines the absolute need to implement HIV screening among women who plan to have an abortion, together with sexual and general health-promoting counselling. Our results indicate that these women may already be HIV-infected, or may have been infected at conception of the terminated pregnancy, or may acquire HIV in the future. Moreover, our study demonstrates that, even now, women who have been living with HIV for a long time and who are receiving cART have a fear of vertical HIV transmission.