Factors associated with acceptance of postpartum tubal ligation among HIV infected women.

Objective. To identify the factors associated with the acceptance of tubal ligation after childbirth among HIV-infected patients. Material and methods . A case-control study was conducted from March 1988 to February 1999, at M exico's National Institute of Perinatology (INPer), in 72 HIV-positive preg nant women. Cases were 49 women who accepted postpartum tubal ligation afte r childbirth, and controls were 23 women who refused this birth control met hod. Data collected for each patient were demographic characteristics, sexu al and reproductive history, and HIV status. Statistical analysis consisted of descriptive measures, Chi(2) or Fisher's exact test for categorical var iables, and Student's t test for continuous variables. Odds ratios (OR) wit h 95% CI were used to compare groups and potential confounders were assesse d by stratified analysis with the Mantel-Haenszel method. Results. The pati ents' mean age was 25.5 +/- 5.5 years. The median gestation period was 27 w eeks (range 7 to 40 weeks); 16 women (22.2%) had no prenatal care visits at INPer. The median time of HIV positivist awareness was 9 months (range 1 t o 108).Variables associated with acceptance of tubal ligation were: having a prior childbirth (OR 11.1,95% CI 3.4 to 36), pregnancy care from 1995 onw ard (OR 4.7, 95% CI 1.7 to 13.3), and having given birth to an HIV-infected child (OR 4.6, 95% CI 1.05 to 23.1). Stratified analysis showed no modific ation of the strength of association of these variables with acceptance of tubal ligation. Conclusions. A prior childbirth was the most important pred ictor of tubal ligation acceptance. The English version of this paper is av ailable at: http://www.insp.mx/salud/index.html.