HIV-INFECTION AMONG WOMEN UNDERGOING ABORTION IN MONTREAL

Objective: To determine the seroprevalence and correlates of HIV infec tion in a subpopulation of women of childbearing age in Montreal. Desi gn: Anonymous unlinked seroprevalence study. Setting: Pregnancy termin ation unit in a teaching hospital in Montreal. Participants: Women pre senting for abortion from July 1989 to lune 1993 who resided in Quebec and were not known to have HIV infection, 12017 (99.6%) of 12068 elig ible women were included in the study. Intervention: HIV antibody test ing of serum left over from samples obtained for routine Rh typing, th e same algorithm as for serodiagnostic testing, namely enzyme immunoas say (EIA) followed by confirmatory testing of repeatedly EIA-reactive samples, was used. Outcome measures: HIV serostatus by age, marital st atus, region of residence (metropolitan Montreal Versus other), countr y of birth and number of living children. Results: Most (84.7%) of the subjects resided in metropolitan Montreal. The median age was 27.0 (r ange 13 to 50) years. The serum samples of 22 women were confirmed to be HIV positive, for an overall seroprevalence rate of 1.8 per 1000 (9 5% confidence interval 1.1 to 2.8). The seroprevalence rate did not va ry significantly by age, marital status, region of residence or study year. However, it was strongly correlated with country of birth: Canad a 0.16, Haiti 23.5, HIV-endemic countries other than Haiti 5.3 and non -HIV-endemic countries other than Canada 0.0 per 1000. The. seropreval ence rate among women born in Haiti was 147 times higher than that amo ng women born in Canada (P < 0.0001). Of the women born in Haiti the r ate was 3.0 times greater among those who immigrated to Canada in 1985 or later than among those who immigrated earlier (P = 0.047). Conclus ions: The results of this study indicate that the HIV seroprevalence r ate among women in Montreal is strongly associated with country of bir th, women born in HIV-endemic countries, especially Haiti, having the highest rate. These results will help in the development of policies r egarding HIV an tibody testing and prevention of HIV transmission in Q uebec.