HIV Sentinel Surveillance Among Women Seeking Elective Pregnancy Termination, San Francisco

The researchers sought to study HIV prevalence, incidence and risk factors among women seeking elective pregnancy termination in San Francisco. They conducted a cross-sectional survey of a consecutive sample of women seeking elective pregnancy termination in San Francisco's county hospital from August 2002 to July 2003. Routine clinic records provided demographic and risk-behavior information. HIV testing was conducted on blood samples collected for other purposes. Identifying information was removed from the samples.

Among the 1,992 women tested, 11 were found to be HIV-positive; this yielded a prevalence rate of 0.55 percent (95 percent confidence interval [CI], 0.28-0.99). One recent HIV seroconversion was detected for an annual incidence of 0.11 percent (95 percent CI, 0.23-0.88). Risk factors significantly associated with HIV infection included sex with a man known to be HIV-positive, history of an abnormal Pap test, history of genital herpes infection, history of trichomoniasis, and age 25-29 years.

"Women electing pregnancy termination can serve as a sentinel population to track trends in the HIV epidemic," the authors concluded. "However, barriers remain to wider implementation of the approach as a surveillance tool."