Drivers of Sexual Inactivity Among Women Living with HIV and AIDS: Findings of the GENIH Study in São Paulo, Brazil
The advances on HIV/AIDS diagnosis and treatment have enabled people living with HIV/AIDS (PLHA) better quality of life. However, the persistence of HIV-related stigma and discrimination, and the risks triggered by HIV disclosure, may be a barrier to the sexual exercise of PLHA. We investigated the prevalence of sexual inactivity and the reasons given for it among a representative sample of women of reproductive age living with HIV/AIDS (WLWHA) in the municipality of São Paulo, Brazil. We surveyed 918 WLWHA with probability proportional to average number of visits in each of the 18 referral HIV/AIDS services. Sexual inactivity was defined as not having had vaginal sexual intercourse in the year prior to research. Statistical modeling of the factors associated with sexual inactivity was carried out by way of bivariate and multivariate analysis. In all, 22.2% (n = 200) of the women did not have sexual relations in the year prior to the interview. The majority reported a reduction in desire (64.5%) and sexual activity (68%). Among the women not in a relationship, the predictors of sexual inactivity were: being older (35–49) (ORa = 2.25); not being Catholic (ORa = 2.91); having kept the diagnosis secret from their partner (ORa = 2.45); having had up to five sexual partners throughout life (ORa = 3.81). The diagnosis of HIV seems to have more of an effect on the desire for and frequency of sexual activity than on its interruption. Sexual inactivity was influenced by the stigma of HIV/AIDS, by age, and by moral-religious values.
KeywordsSexuality Women HIV Sexual rights
This study was funded by São Paulo Research Foundation (# 2012/25239-3), Pan-American Health Organization (#BR_LOA_1200041; # BR_LOA_1200124) and Brazilian Council for Scientific and Technological Development (#471892/2011-4; #478296/2012-6).
AAP participated in the design and implementation of the GENIH study, and all of the stages of development of this article. RB coordinated the GENIH study and participated in the article’s revision. SM and WV participated in the conceptualization of the article and its revision. SB participated in the statistical analysis and revision of the article.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was submitted and approved by four different research ethics committees: The Research Ethics Committee of the Center for Referrals and Training in STDs/AIDS of the Secretary of the Health of the State of São Paulo (# 022/2011); The Research Ethics Committee of the Emílio Ribas Institute of Infectology (#11712112.6.0000.5375); The Research Ethics Committee of the Secretary of Health of the City of São Paulo (# 0043;12); and the Research Ethics Committee of the Federal University of São Paulo (#11712112.6.0000.5375).
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