Population base, national scope, direct estimate |
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Cecatti et al. 1010. Cecatti JG, Guerra GV, Sousa MH, Menezes GM. Aborto no Brasil: um enfoque demográfico. Rev Bras Ginecol Obstet 2010; 32:105-11.
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Brazil (1996). |
Household population survey. Direct estimate. 1996 PNDS. |
12,612 women aged 15-49 years. |
Information on abortion obtain through direct interview, subject to under-reporting; Does not present CI of estimates; 85.5% response rate, with no information provided to evaluate whether refusals were selective. |
Unsafe abortions prevalence: 2.4%. Regional inequalities: Northest (3.1%), North (2.3%), South (1.7%) and Central (1.3%). Rio de Janeiro (6.5%). Associated factors: - Age: growing prevalence from 15-19 years (0.5%) to > 40 years (4.5%); - Residence: urban > rural; - Non-religious > religious; - Higher educational level > lower educational level (3.7%). |
Camargo et al. 1111. Camargo RS, Santana DS, Cecatti JG, Pacagnella RC, Tedesco RP, Melo Jr. EF, et al. Severe maternal morbidity and factors associated with the occurrence of abortion in Brazil. Int J Gynaecol Obstet 2011; 112:88-92.
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Brazil (2006). |
Household population survey. Direct estimate. 2006 PNDS. |
15,775 women aged 15-49 years, 4,340 of whom with children born alive in the past 5 years. |
Information on abortion obtain through direct interview, subject to under-reporting; Does not present CI of estimates; 11% loss of eligible women in urban regions and 9.4% in rural regions, with no information provided to evaluate whether refusals were selective. |
Unsafe abortions prevalence over reproductive life: 2.3% and among women with previous pregnancies: 3.3%; Regional inequalities: North (4.3%), Northeast (3.5%), Southeast (1.8%); Central (1.3%) and South (0.8%); unsafe abortions prevalence: 1.8% among women who had been pregnant in the previous 5 years. |
Diniz & Medeiros 1212. Diniz D, Medeiros M. Aborto no Brasil: uma pesquisa domiciliar com técnica de urna. Ciênc Saúde Colet 2010; 15 Suppl 1:959-66.
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Brazil (2010). |
Household population survey using ballot box technique. Direct estimate. 2010 PNA. |
2,002 literate women residing in urban areas. Age: 18-39 years. |
Does not inform all parameters used to calculate sample size (only error margin and estimate precision); does not include the entire reproductive period (only 18-39 years), or illiterate women or women from rural regions; does not inform if the design effect was incorporated into the analysis (cluster sampling); does not inform proportion of losses and refusals. |
Induced abortion prevalence: 15%; By age group: smaller among women aged 18-19 years (6%) and increases to 22% in the 35-39 years; Among those who had abortions: peak 20-24 years; Among those with low educational levels: 23% and high educational levels: 14%; No differences according to religion; Half used medication and 55% needed hospitalization. |
Diniz et al. 1313. Diniz D, Medeiros M, Madeiro A. Pesquisa Nacional de Aborto 2016. Ciênc Saúde Colet 2017; 22:653-60.
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Brazil (2016). |
Household population survey using ballot box technique. Direct estimate. 2016 PNA. |
2,002 literate women residing in urban areas. Age: 18-39 years. |
Does not inform all parameters used to calculate sample size (only error margin and estimate precision); does not include the entire reproductive period (only 18-39 years), or illiterate women or women from rural regions; does not inform if the design effect was incorporated into the analysis (cluster sampling); does not inform proportion of losses and refusals. |
Induced abortion prevalence: 13%; By age group: smaller among women aged 18-19 years (9%) and increases to 18% in the 35-39 years; Among those who had abortions: peak 20-24 years; Among those with low educational levels: 22% and high educational levels: 11%; No differences according to religion; According to race/color: black and brown (14 to 15%) and white (9%); Half used medication; 48% needed hospitalization (< than in 2010); Estimate of 503 thousand unsafe abortions in 2015. |
Massaro et al. 1414. Massaro LTS, Abdalla RR, Laranjeira R, Caetano R, Pinsky I, Madruga CS. Alcohol misuse among women in Brazil: recent trends and associations with unprotected sex, early pregnancy, and abortion. Braz J Psychiatry 2019; 41:131-7.
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Brazil (2006 e 2012). |
Household population survey. Direct estimate. LENAD 2012. |
2,537 women aged ≥ 14 years. |
Does not inform parameters used to calculate sample size; unsafe abortions measured by direct interview, subject to under-reporting; Does not describe characteristics of the studied sample; it is not possible to evaluate temporality between alcohol use and unsafe abortions. |
Lifetime abortion prevalence - 26.3% (14.5-18.3) in the entire sample; 15% (13.2-17.0) among women with no binge drinking or AUD; 20.4% (15.3-26.7) among women with binge drinking, but without AUD; 24.9% (16.3-36.2) among women with binge drinking and AUD. |
Population base, national scope, indirect estimate |
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Martins-Melo et al. 1515. Martins-Melo FR, Lima MS, Alencar CH, Ramos Jr. AN, Carvalho FH, Machado MM, et al. Tendência temporal e distribuição espacial do aborto inseguro no Brasil, 1996-2012. Rev Saúde Pública 2014; 48:508-20.
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Brazil (1996-2012). |
Ecological. Temporal and spacial dimension. Hospital study (SUS users). Indirect estimate. |
Around 4 million hospitalizations from abortion in SIH/SUS (ICD-10 codes:O-00-O-08). |
No limitations identified. One item (response rate) not applicable. |
Estimate of 994 thousand unsafe abortions/year; Mean UA/WRA coefficient: 17/1,000. UA/LB ratio: 33/100 live birth; Higher elevated indicators in the Northeast (21/1,000 women of reproductive age and 40/100 live birth); Decline over time at the national level, with regional differences; For UA/WRA: constant decreasing trend in Northeast, Central and Southeast; stability in the South; non-constant growing trend in the North; For the UA/LB ratio: constant growing in the North, Central and S, decreasing in the Southeast and Northeast; For both indicators, differences were also found between states; Spatial distribution, clusters in North, Northeast and Southeast regions. |
Monteiro et al. 1616. Monteiro MFG, Adesse L, Drezett J. Atualização das estimativas da magnitude do aborto induzido, taxas por mil mulheres e razões por 100 nascimentos vivos do aborto induzido por faixa etária e grandes regiões. Brasil, 1995 a 2013. Reprod Clim 2015; 30:11-8.
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Brazil (1995-2013). |
Time series. Hospital-based study (SUS users). Indirect estimate. |
N ≥ 4 million hospitalizations. Age: 15-49 years. |
Does not inform ICD-10 codes used for the indirect estimate of abortion cases; does not use statistical tests to assess time variations; One item (response rate) not applicable. |
Maximum abortion estimate: 1,086,708 in 1995 and 865,160 in 2013. Minimum estimate: 864,628 and 697,347 in 2013; Global reduction of unsafe abortions/1,000 women of reproductive age: from 27-16. In regions: North (29-21); Northeast (38-18) and Southeast (25-14); stable South; Central unstable reduction. 27% reduction in the number of hospitalizations; greater for those aged 20-29 years (-38%) and 15-19 years (-35%). Reduction in the number of abortions/100 live birth: from 35/100 in 2004 to 30/100 live birth in the Northeast (38-28) and Southeast (25-14). Reduction of unsafe abortions/1,000 women of reproductive age: from 30 to 17 in the age group 15-19 years; from 43 to 22 (20-29 years); from 23 to 17 (30-39 years). |
Hospital base, national scope, direct estimate |
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Machado et al. 1717. Machado CJ, Lobato AC, Melo VH, Guimarães MD. Perdas fetais espontâneas e voluntárias no Brasil em 1999-2000: um estudo de fatores associados. Rev Bras Epidemiol 2013; 16:18-29.
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Brazil (2006). |
Multicenter cross-sectional study. Hospital-based (SUS reference maternities). Direct estimates. |
1,838 puerperae with previous pregnancies (of 3,047). |
Sample obtained from reference maternity hospitals in the national STI/AIDS program. It is not clear if this sample can be considered representative of women of reproductive age; Parameters used to calculate sample size related to prevalence of syphilis during pregnancy; sub-sample of women with previous pregnancies used to estimate frequency of unsafe abortions; Proportion of losses not reported, only proportion of refusals; Induced abortions estimated based on the difference between total losses and miscarriages, with the latter information obtained from direct interviews, subjected to under-reporting; Did not incorporate design effect into the analysis; did not present CI of obtained estimates. |
Unsafe abortions prevalence: 9,7%. |
Population base, local scope, indirect estimate |
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Mello et al. 1919. Mello FM, Sousa JL, Figueroa JN. Magnitude do aborto inseguro em Pernambuco, Brasil, 1996 a 2006. Cad Saúde Pública 2011; 27:87-93.
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Pernambuco State, Brazil (1996-2006). |
Ecological. Temporal and spatial dimensions. Restricted to SUS users. Indirect estimate. |
147,205 hospitalizations from abortion in SIH-SUS. (ICD-10 codes: O00 and O03 -O06) |
Does not use all ICD-10 codes related to abortion and does not justify the criterion they used; One item (response rate) not applicable. |
Estimates of 65,457 abortions/year; Greater concentration in GERES I and IV. Higher indicator in GERES I and VIII, around 40/100 live birth; Unequal temporal decline, more intense in GERESI; GERES X and XI had an increase in the indicator; Decline in the total number of abortions in the state, last year of the series: 51,853 abortions. |
Madeiro et al. 2020. Madeiro AP, Rufino AC, Santos IS, Carvalho MS. Estimativas e tendências de aborto provocado no Piauí: um estudo ecológico no período de 2000-2010. Rev Bras Promoc Saúde 2015; 28:168-75.
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Piauí, Brazil (2000-2010). |
Ecological. Temporal and spatial dimensions. Restricted to SUS users. Indirect estimate. |
55,678 hospitalizations from abortion in SIH-SUS. (ICD-10 codes: O03 -O07). |
Does not justify ICD-10 codes used to identify hospitalizations from abortion; One item (response rate) not applicable. |
Estimated number of unsafe abortions dropped from 10,362 (2000) to 6,738 (2010); UA/LB ratio for the state dropped from 17.6 to 13.5 with significant annual reduction of 2.2%. Region TD4 was the most responsible, with 40% population and reduction from 16.7 to 6.9; Other regions with increase or stability. |
Population base, local scope, women of reproductive age, direct estimate |
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Silva & Vieira 2121. Silva RS, Vieira EM. Frequency and characteristics of induced abortion among married and single women in São Paulo, Brazil. Cad Saúde Pública 2009; 25:179-87.
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São Paulo, Brazil (1993). |
Household survey. Population base. Direct and RRT estimates. |
1,749, age 15-49 years; Two sub-samples: one with measurement of unsafe abortions in the previous year by RRT (n = 876) and another with measurement by direct interview (n = 873); In both sub-samples, measurement of lifetime unsafe abortions through direct interview; Exclusion of 317 women who were separated, in consensual unions or widowed. |
Non-probabilistic samples; Unclear parameters for calculating sample size and sampling procedure; Uninformed losses and refusals. Does not describe sample characteristics; Lifetime unsafe abortions measured through direct interviews, subjected to under-reporting; Does not present CI of unsafe abortions estimates. |
Unsafe abortions prevalence in the previous year: Measurement through direct interview: 1 per 1,000; Measurement by RRT: 42 per 1,000; Prevalence of lifetime abortion (direct interview): 45 unsafe abortions per 1,000 women, 4.4% of pregnancies ended in unsafe abortions; Among married women (n = 764): 45 unsafe abortions per 1,000, 90% of women with previous pregnancy, 2% ended in unsafe abortions; Among single women (n = 658): 49 unsafe abortions per 1,000, 16% of women with previous pregnancy, 18% ended in unsafe abortions. |
Souza et al. 2222. Souza MG, Fusco CLB, Andreoni SA, Souza e Silva R. Prevalência e características sociodemográficas de mulheres com aborto provocado em uma amostra da população da Cidade de São Paulo, Brasil. Rev Bras Epidemiol 2014; 17:297-312.
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São Paulo, Brazil (2008). |
Household survey. Population base. Direct estimate. |
683 women with previous pregnancies; age: 15-59 years. |
Does not inform parameters used to calculate sample size; Apparent underestimation of young women, indicating probable failure in the sample selection; Information on abortion obtained through direct interview, subject to under-reporting; Does not inform proportions of loss and refusal; Does not present CI of estimates. |
Unsafe abortions prevalence: 4.5%. Higher among single women (10.1%) in those with 5 or more live birth (14.3%) and the ones who use ineffective contraception (7.7%). |
Fusco et al. 2323. Fusco CLB, Silva RS, Andreoni S. Unsafe abortion: social determinants and health inequities in a vulnerable population in São Paulo, Brazil. Cad Saúde Pública 2012; 28:709-19.
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Favela Inajar, São Paulo, Brazil (2005/2006). |
Household survey. Population base. Direct estimate. |
375 women, 278 with previous pregnancies; Age = 15-54 years. |
Unsafe abortions measured through direct interviews, subjected to under-reporting. Does not present confidence intervals for the estimates. |
Global unsafe abortions prevalence: 13.6%; Among black women and with low educational levels - 35.7%, black with low income - 40%; black and single - 36.7%; Prevalence among women with some pregnancy - 18.35. |
Santos et al. 2424. Santos TF, Andreoni S, Souza e Silva R. Prevalência e características de aborto induzido - Favela México 70, São Vicente - São Paulo. Rev Bras Epidemiol 2012; 15:123-33.
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Favela México 70, São Vicente, São Paulo State, Brasil (2008). |
Household survey. Population base. Direct estimate. |
735 women with previous pregnancies; Age: 15-49 years. |
It is not clear if the method used for the selection of women may have generated some selection bias; Measurement of abortion through direct interviews, subjected to under-reporting; Does not inform the proportion of losses and refusals; Does not present a confidence interval of estimates. |
Prevalence 6.9%. In the group 40 to 45 years: 12.9%; with low educational level: 11.4%; no children: 15.2% and with 6 or more children: 12.2%. |
Population base, local or regional scope, young population, direct estimate |
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Silva & Andreoni 2525. Silva RS, Andreoni S. Fatores associados ao aborto induzido entre jovens pobres na cidade de São Paulo, 2007. Rev Bras Estud Popul 2012; 29:409-19.
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Freguesia do Ó community, São Paulo State, Brazil (2007). |
Household survey. Population base. Direct estimate. |
Sexually active youths: 102 men and 99 women; Age: 15-25 years. |
Measurement of induced abortion through direct interviews, subjected to under-reported; Does not present confidence intervals for the estimates. |
Unsafe abortions prevalence men (partners): 10.8%; Unsafe abortions prevalence among women: 6.1% |
Silva & Fusco 2626. Silva RS, Fusco CLB. Comportamento do aborto induzido entre jovens em situação de pobreza de ambos os sexos - Favela México 70, São Paulo, Brasil, 2013. Reprod Clim 2016; 31:13-21.
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Favela México 70, São Vicente, São Paulo, Brazil (2013). |
Household survey. Population base. Direct estimate. |
Sexually active youths: 327 women and 253 men; Age: 15-24 years. |
Measurement of induced abortion through direct interviews, subjected to under-reported; Does not present confidence intervals for the estimates. |
Unsafe abortions prevalence men (partners): 2.8%; Unsafe abortions prevalence among women: 1.2%. |
Pilecco et al. 2727. Pilecco FB, Knauth DR, Vigo A. Aborto e coerção sexual: o contexto de vulnerabilidade entre mulheres jovens. Cad Saúde Pública 2011; 27:427-39.
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Rio de Janeiro, Porto Alegre (Rio Grande do Sul State) e Salvador (Bahia State), Brazil (2001-2002). |
Household survey. GRAVAD study. Population base. Direct estimate. |
870 young women (18-24 years) with previous pregnancies. |
Does not inform parameters used when calculating the sample size; Measurement of induced abortion through direct interviews, subjected to under-reported; Does not present data that enabled an evaluation of whether losses (14.8%) were selective; Does not present confidence intervals for the estimates. |
Prevalence: 21.5% among those who had become pregnant; Rio de Janeiro (52.8%), Salvador (42.1%), Porto Alegre (5.1%). |
School base, local scope, young population, direct estimate |
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Correia et al. 2828. Correia DS, Cavalcante JC, Egito ES, Maia EMC. Prática do abortamento entre adolescentes: um estudo em dez escolas de Maceió - AL, Brasil. Ciênc Saúde Colet 2011; 16:2469-76.
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Maceió, Alagoas State, Brazil (2005). |
Cross-sectional. Restricted to schools (public and private). Direct estimate, self-administered questionnaires, in the school environment. |
Age: 12-19 years, 2,592 students. In this analysis, N = 559 (sexually active girls). |
Only adolescent students; Unclear sampling procedure; Unsafe abortions measured through a self-administered questionnaire, in a school environment, with a possibility of under-reporting; No confidence interval for estimates; Does not incorporate design effect in the analyses; Did not inform losses and refusals. |
Unsafe abortion prevalence: 26.7% for the total of sexually active girls and 81.9% among those who became pregnant. |
Population or service base, local scope, specific populations, direct estimate |
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Neiva-Silva et al. 2929. Neiva-Silva L, Demenech LM, Moreira LR, Oliveira AT, Carvalho FT, Paludo SDS. Pregnancy and abortion experience among children, adolescents and youths living on the streets. Ciênc Saúde Colet 2018; 23:1055-66.
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Porto Alegre e Rio Grande (Rio Grande do Sul State), Brazil (2008). |
Cross-sectional, RDS sampling. |
307 homeless children, adolescents and youths of both sexes, aged 10-21 years. Two hundred and four in Porto Alegre, 103 in Rio Grande. |
Abortion measured through direct interview. Abortion type (induced or miscarriage) asked only for the first abortion, with 32% reporting more than one abortion. Possibility of unsafe abortions under-reporting; CI of estimates not presented. |
81,1% male sex, 93.8% between 12-21 years, 29.3% with experience with pregnancy, 26.7% of whom aged ≤ 14 years; 15.6% unsafe abortions prevalence among individuals with previous experience of pregnancy; Greater abortion experience (miscarriage or unsafe abortion) among girls than among boys (17.4% vs. 8.8%). |
Barbosa et al. 3030. Barbosa RM, Pinho AA, Santos NS, Filipe E, Villela W, Aidar T. Induced abortion in women of reproductive age living with and without HIV/Aids in Brazil. Ciênc Saúde Colet 2009; 14:1085-99.
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Thirteen Brazilian municipalities from the 5 macro-regions (2003-2004). |
Cross-sectional. Self-administered questionnaire in HIV/AIDS reference services and in primary health units and women’s health care services. Direct estimates. |
Women aged 18-49 years, literate, sexually active; 1,777 WLHA; 2,045 WNLHA. |
Convenience sample; Under-representation of WLHA in the North Region and over-representation in the Southeast Region; CI of estimates not presented. |
Lifetime unsafe abortion prevalence: WLHA: 17.5%; WNLHA: 10.4%, p < 0.001; Non-significant differences after adjusting for age, marital state, number of children and lifetime sexual partners: WLHA 13,3% vs. WNLHA 11,0%; p > 0,05). |
Pilecco et al. 3131. Pilecco FB, Teixeira LB, Vigo A, Dewey ME, Knauth DR. Lifetime induced abortion: a comparison between women living and not living with HIV. PLoS One 2014; 9:e95570.
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Porto Alegre, Rio Grande do Sul State, Brazil (2011). |
Cross-sectional. Interviews in 7 and 27 primary health services. Direct estimates. |
Women with previous pregnancies; 18-49 years; 625 WLHA; 498 WNLHA. |
Unclear procedure for selecting primary health units; unsafe abortions measured through direct interviews, subject to under-reporting; CI of estimates not presented. |
Lifetime unsafe abortion prevalence: WLHA: 13.0%; WNLHA: 4.9%; Pregnancies resulting in unsafe abortion: WLHA: 6.5% (7.7% before diagnosis of the infection, 3.8% after diagnosis of the infection, p = 0.024); WNLHA: 2.9%. |
Pinho et al. 3232. Pinho AA, Cabral CDS, Barbosa RM. Differences and similarities in women living and not living with HIV: contributions by the GENIH study to sexual and reproductive healthcare. Cad Saúde Pública 2017; 33:e00057916.
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São Paulo, Brazil (2013-2014). |
Cross-sectional. Interviews in 18 HIV/AIDS reference services and 38 primary health services. Direct estimates. |
Sexually active women; 18-49 years; 918 WLHA;1,003 (WNLHA). |
High percentage of refusals (27% among WLHA, 26.5% among WNLHA); Characteristics not describe, uncertain selection bias; unsafe abortions measured through direct interviews, subject to under-reporting; CI of estimates not presented. |
Lifetime unsafe abortions prevalence among women with previous pregnancies: WLHA: 14.1%; WNLHA: 3.02. |
Friedman et al. 3333. Friedman RK, Bastos FI, Leite IC, Veloso VG, Moreira RI, Cardoso SW, et al. Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil. Rev Saúde Pública 2011; 45:373-81.
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Rio de Janeiro, Brazil (1996-2003). |
Prospective cohort STI/AIDS reference center Direct estimate through interview |
225 women living with HIV/AIDS > 18 years. |
Unsafe abortions measured through direct interview, subject to under-reporting. |
Unsafe abortions incidence: 2.1% (95%CI: 1.2%-3.0%) women year; Of the 60 pregnancies that occurred during follow up, 31% resulted in unsafe abortions. |
Madeiro & Rufino 3434. Madeiro AP, Rufino AC. Aborto induzido entre prostitutas: um levantamento pela técnica de urna em Teresina - Piauí. Ciênc Saúde Colet 2012; 17:1735-43.
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Teresina, Piauí, Brazil (2011). |
Cross-sectional. Workplace interviews. Population. Direct estimate. |
310 female sex workers; 18-39 years. |
Non-probabilistic sample, not including the entire reproductive range, with the exclusion of illiterate women and majority inclusion of women working in brothels (under-representation of women working on the streets). Did not present CI of estimates. |
52.6% prevalence. Age groups: 18-19 years: 27.1%; 35-39 years: 71.2%; 3 or more previous pregnancies: 94.7%; More than 10 years working in prostitution: 61.3%; Misoprostol used in over 70% of cases. |
Diehl et al. 3535. Diehl A, Pillon SC, Santos MA, Laranjeira R. Abortion and sex-related conditions in substance-dependent Brazilian patients. Cad Saúde Pública 2017; 33:e00143416.
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São Paulo, Brazil (2009-2011). |
Cross-sectional; Interviews 15 days after admission to a clinic specialized in addiction treatment. |
Patients aged ≥ 18 years, with confirmed clinical diagnosis of addiction; Using DSM-IV-TR N = 616; 82.5% male sex. |
Does not inform parameters used to calculate sample size; unsafe abortions measured through direct interviews, subject to under-reporting (in men, experience with induced abortion measured); Did not present CI of estimates. |
26.8% prevalence; In men: 23.8%; In women: 40.7% |