Factors associated with induced abortion in women prostitutes in Asturias (Spain).

Background: The aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain).

Methodology/principal Findings: Cross-sectional descriptive study by self-completion questionnaire of 212 women prostitutes who attended the three Sexually Transmitted Disease Clinics in Asturias, between January-December 2003. The questionnaire was designed to investigate the women's perceived knowledge (what they claimed to know), their real knowledge (what they really knew), the use of contraceptive methods and socio-demographic variables. Multivariate analysis was carried out. 92% of the participants were immigrants. 76% were practising at brothel. 37.6% (95%CI:30.7-44.4%) reported to have undergone at least one IA during their life. According to the logistic regression the "presence of IA" was directly associated with the variables "number of pregnancies" (OR:65.82;95%IC:7.73-560.14) and "years of practising prostitution" (OR:1.13;95%CI:0.99-1.29); and inversely associated with "children" (0 = no children;1 = one or more children; OR:0.005;95%CI:0.000-0.057), "women's age" (OR:0.89;95%CI:0.82-0.97) and "real contraceptive knowledge" (OR:0.50; 95%CI:0.34-0.75). Married women were more likely to have undergone an IA (OR:2.74;95%IC:1.05-7.13). No association with "perceived contraceptive knowledge" was found.

Conclusions/significance: The characteristics more closely linked to the reproductive history of the women (such as "pregnancies", "children"), together with the "real contraceptive knowledge" and the "time practising prostitution" explain the presence of IA better than factors more closely linked to the conditions in which the women practise prostitution ("place of activity", "other activities compatible with prostitution", "use of safe method in commercial relation"). It is possible that IA is being used as a birth control method, hypothesis suggested by the inverse association observed between the variable "children" and the "presence of IA". Therefore, the promotion of the use of safe contraceptive methods should be a high-priority. If the real contraceptive knowledge was measured correctly, all strategies to increase it would be justified because it was inversely associated with the presence of IA.