Medical and surgical abortion for women living with HIV

We reviewed the evidence regarding the safety and success of medical and surgical abortion among women living with HIV. Our main question was: Are there differences in the safety and success of medical abortion versus surgical abortion for women living with HIV? Our secondary questions were: (1) Do outcomes of medical and surgical abortion differ between women living with HIV and women without HIV?; and (2) What outcomes of medical and surgical abortion have been reported for women living with HIV?

Background

The World Health Organization (WHO) guidelines for safe abortion recommend medical abortion with mifepristone and misoprostol or surgical abortion with vacuum aspiration or dilation and evacuation as safe and successful options for women. However, the guidelines make no specific clinical considerations for women living with HIV.

Study characteristics

The evidence is current to 17 April 2018. Of the 3840 records screened, we identified only one unpublished study that met our inclusion criteria. The intervention focused on women living in Ukraine with HIV undergoing medical abortion at home.

Key results

The quality of evidence was low but found that medical abortion was successful with no major complications experienced among women living with HIV.

Quality of the evidence

The results from this review do not provide enough evidence to determine if differences exist in abortion outcomes for women living with HIV, but also no evidence was found showing that abortion is unsafe in this population. As it is important for all women to have access to safe abortion to combat the public health threat of high rates of maternal deaths, healthcare providers should not be deterred from providing access to safe abortion to their patients living with HIV.

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