Abortion and its association with antiretroviral therapy among young women living with HIV in northern Uganda: a cross-sectional study.

Introduction: Abortion is a critical reproductive health issue among young women living with HIV (YWLHIV). Despite the widespread use of the antiretroviral therapy (ART) for women of reproductive age, its impact on abortion prevalence remains unclear. We set out to determine the prevalence of abortion among the YWLHIV receiving TLD-based ART regimen in northern Uganda and its association with the ART regimen and duration alongside other key socio-demographic, reproductive health, lifestyle and facility access- related factors.

Methods: A cross-sectional study of YWLHIV who reported at least one pregnancy in northern Uganda. Using an interviewer-administered questionnaire, participants were asked about their abortion history, ART regimen and duration, contraceptive use, parity, male partner's HIV status, and access to community-based family planning resources. Descriptive statistics for abortion prevalence, Chi-square test, Fisher's Exact test, bivariate and multivariate Poisson regression analyses for the associations between these variables and the occurrence of abortion were used. The 5% significance level and 95% confidence intervals were considered.

Results: We analyzed data of 268 YWLHIV who reported conceiving at least one pregnancy. The abortion prevalence was 20.9% (95% Confidence Interval (CI) of 16.2% - 26.1%). No significant association was found between the abortion experience and ART regimens nor duration. The significant predictors for abortion included awareness of public health facilities that provide family planning services, parity, sero-concordant HIV-positive partnerships, and modern contraceptive use.

Conclusion: This study found a substantial abortion prevalence of 20.9% among the YWLHIV in northern Uganda. There was no significant association between the occurrence of abortion and ART regimens nor duration. Key predictors of abortion included awareness of public health facilities that provide family planning services, parity, use of contraceptive methods and the male partner's HIV positive status. To reduce abortion, creation of awareness of public health facilities that provide family planning services, contraceptive use, and couple-focused HIV testing and status disclosure are recommended.