96 (95% CI 0.94–0.99) per 1 year older; P = 0.009] and IDU [ARR 1.38 (95% CI 0.98–1.94)] vs. sexually transmitted HIV [ARR 1.38 (95% CI 0.98–1.94); P = 0.01] were independent predictors of abortion. To evaluate the impact of HIV-related factors on the incidence of first abortion, we then focused on the 60 events that occurred during 4349 PYFU after HIV diagnosis [crude incidence rate 13.8 per 1000 PYFU (95% CI 10.7–17.8)]. We observed a high incidence rate of induced abortion among women who acquired HIV by IDU [23.0 per 1000 PYFU (95% CI 15.5–34.0)] and those who were not on cART and were aware of being HIV-infected before pregnancy

[7.6 per 1000 PYFU (95% CI 19.5–39.9)]. Further, women who self-reported a fear of vertical HIV transmission [22.9 per 1000 PYFU (95% CI 15.3–34.2)] or of con-natal malformations [19.7 per 1000 PYFU (95% CI 10.7–35.1)] had high abortion incidence rates. Conversely, a low

incidence rate was observed in women who were already Selleckchem Doxorubicin aware of their HIV infection and who were on cART at the time of the abortion [8.6 per 1000 PYFU (95% CI 5.7–12.8)] and those who declared a monthly income higher than €800 [9.4 per 1000 PYFU (95% CI 6.1–14.4)]. The abortion incidence rate in migrant women living with HIV was even lower [3.5 per 1000 PYFU (95% CI 0.5–24.8)]. In the multivariable model, the risk of first abortion was significantly lower in more recent calendar years. In fact, compared with the period before 1990, the risk of first BTK inhibitors abortion was 0.47 (95% CI 0.22–0.99; P = 0.04) in 1990–1999 and 0.37 (95% CI 0.13–1.02; P = 0.05) in 2000–2010. Among women who were aware of their HIV infection before pregnancy, the current use of cART was protective against abortion [receiving vs. not receiving cART, ARR 0.54 (95% CI 0.28–1.04); P = .06]; women who had a diagnosis at pregnancy did not show an increased risk of abortion compared with those who were already aware of their infection and who were off

cART [HIV diagnosed during pregnancy vs. already aware of HIV Cediranib (AZD2171) infection and not receiving cART, ARR 0.84 (95% CI 0.37–1.90); P = 0.68]. Fear of vertical transmission was strongly associated with abortion after HIV diagnosis: women who were concerned about infecting the child showed a twofold higher risk of abortion compared with those who were not [ARR 1.90 (95% CI 1.02–3.56); P = 0.04]. Monthly income lower than €800 [ARR 1.76 (95% CI 0.99–3.11); P = 0.05 vs. monthly income ≥ €800] and younger age [per 1 year older, ARR 0.95 (95% CI 0.91–1.00); P = 0.05] were also found to be independent predictors of first abortion after HIV diagnosis. The risk of abortion in women who became sexually active before 15 years of age tended to be higher [ARR 1.65 (95% CI 0.91–2.98); P = 0.09].