HIV sentinel surveillance among women seeking elective pregnancy termination, San Francisco.

Objective: The objective of this study was to measure HIV prevalence, HIV incidence, and risk factors for infection among women seeking elective pregnancy termination in San Francisco.

Study: The authors conducted a cross-sectional survey comprising a consecutive sample of women seeking elective pregnancy termination in San Francisco's county hospital from August 2002 to July 2003. Demographic and risk behavior information was abstracted from routine clinic records. HIV testing was conducted on blood specimens collected for other purposes after removing identifying information.

Results: Based on 11 HIV-positives among 1,992 tested, HIV prevalence among women seeking pregnancy termination was 0.55% (95% confidence interval [CI], 0.28-0.99). One recent HIV seroconversion was detected for an annual incidence of 0.11% per year (95% CI, 0.23-0.88). In addition, risk factors significantly associated with HIV infection included sex with a known HIV-positive man, history of an abnormal Pap smear, history of genital herpes infection, history of trichomoniasis, and age 25 to 29 years.

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