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Discussing Childbearing with HIV-infected Women of Reproductive Age in Clinical Care: A Comparison of Brazil and the US

AIDS and Behavior volume 16, pages 99–107 (2012)Cite this article

Abstract

Despite long term access to highly active antiretroviral therapy in Brazil and the US, little is known about women’s communication with their HIV provider regarding childbearing or the unmet need for reproductive counseling. We utilized identical survey questions to collect data from HIV-infected women of reproductive age in Rio de Janeiro (n = 180) and Baltimore (n = 181). We conducted univariate analyses to compare findings between samples of women and multivariate logistic regression to determine factors associated with childbearing desires, childbearing intentions, and provider communication among the combined sample of women (n = 361). Over one-third of women in Rio de Janeiro and nearly one-half of women in Baltimore reported the desire for future childbearing. Nevertheless, the majority of women in clinical care had not discussed future childbearing with their HIV provider. Even in countries with an advanced approach to HIV care, we found low and inadequate communication between providers and female patients about childbearing.

Resumen

Al pesar del acceso a largo plazo a la terapia antiretroviral en Brasil y en los Estados Unidos, hay poco conocimiento al respecto de la comunicación entre las mujeres viviendo com VIH y sus médicos en cuanto a sus deseos de tener mas hijos o la necesidad del consejo relacionado con la reproduccion. En este estudio utilizamos preguntas identicas en los dos estudios para coleccionar datos entre las mujeres infectadas con VIH de edad reproductiva, 180 viviendo en Rio de Janeiro y 181 viviendo en Baltimore. Condujimos análisis univariados para comparar los resultados entre las muestras de mujeres y la regressión logistica multivariada para determinar los factores asociados con los deseos de parir, incluyendo las intenciones para parir y la comunicación de los medicos HIV entre 361 mujeres. Más de un tercio de mujeres en Rio de Janeiro y casi una mitad de las mujeres en Baltimore reportaron que desearon parir en el futuro. Sin embargo, la mayoría de las mujeres no había discutido con sus médicos su deseo de parir en el futuro. Aun en los países con un enfoque avanzado en relacion al atendimiento clinic para HIV, nos dimos cuenta que hay una comunicación insuficiente acerca del deseo de tener mas hijos entre los medicos de HIV y sus pacientes.

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Acknowledgments

We thank the women in Rio de Janeiro and Baltimore for their participation in this study and acknowledge The Rio Collaborative Group: Betina Durovni & Rosa Domingues (Municipal Secretariat of Health); Louise Schilkowsky, Lia Adler Cherman, Rosane Messias da Silva, Paulo Roberto N. dos Santos, Naja da Silva Reis, Maria Isabel F. Lima (on behalf of the network of health units); Diego Pacheco & Thais Garcia (field coordinators) and participating clinicians and staff at the study clinics. The study in Brazil was funded by the Ford Foundation, Brazil office. We also thank the HIV Women’s Program in Baltimore for their financial support for participant remuneration.

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Affiliations

  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Sarah Finocchario-Kessler, M. Sweat & D. Kerrigan

  2. Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

    F. I. Bastos, M. Malta & N. Bertoni

  3. Department of Obstetrics & Gynecology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    J. Anderson

  4. HIV Research Group, University of Missouri-Kansas City, Kansas City, MO, USA

    Sarah Finocchario-Kessler & K. Goggin

  5. Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    J. Dariotis

  6. Fulbright/CAPES visiting scholar at Brown University, Providence, RI, USA

    F. I. Bastos

  7. 4825 Troost Ave, #211b, Kansas City, MO, 64110, USA

    Sarah Finocchario-Kessler

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  1. Sarah Finocchario-Kessler
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  2. F. I. Bastos
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  3. M. Malta
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  4. J. Anderson
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  7. J. Dariotis
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  9. D. Kerrigan
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Correspondence to Sarah Finocchario-Kessler.

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Finocchario-Kessler, S., Bastos, F.I., Malta, M. et al. Discussing Childbearing with HIV-infected Women of Reproductive Age in Clinical Care: A Comparison of Brazil and the US. AIDS Behav 16, 99–107 (2012). https://doi.org/10.1007/s10461-011-9906-1

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Keywords

  • Childbearing desires and intentions
  • Fertility
  • Pregnancy
  • HIV clinical care
  • Reproductive counseling
  • Preconception counseling
  • HAART
  • Baltimore
  • Rio de Janeiro
  • Brazil