Condom use among pregnant women living with HIV/AIDS in Porto Alegre, Brazil
T.R. Gonçalves1,2, E.R. Faria1, F.T. Carvalho1,2, M.C. Ramos2, R.S. Lopes1, J.A. Shoveller3, C.A. Piccinini1, B.R. Santos4
1Federal University of Rio Grande do Sul, Postgraduate Program in Psychology, Porto Alegre, Brazil, 2Center for AIDS Studies of Rio Grande do Sul, Porto Alegre, Brazil, 3University of British Columbia, School of Population & Public Health, Vancouver, Canada, 4Conceição Hospital Complex, Infectology Service, Porto Alegre, Brazil
Background: Understanding HIV+ women's sexual behaviour has important implications for public health (e.g., onward transmission) and personal health (e.g., synergistic effects of multiple STIs). However, limited data from Brazilian settings are available regarding sexual behavior among HIV+ women. This clinic-based survey identifies factors associated with condom use among HIV+ women.
Methods: The study used a cross-sectional design, whereby a 72-item survey was administered to 72 HIV+ women attending a clinic for HIV/Aids pre-natal care in Porto Alegre, Brazil. Median age was 28.5; mean number of years of education was 7.4, and 78% were married. All participants were receiving Mother-to-Child Transmission (MTCT) treatment at recruitment; 65% (47) had already been diagnosed with AIDS (CD4 cell count ≤ 350 cells/µl). Both descriptive and multivariate analysis techniques were completed using SPPS.
Results: More than half (40; 55.6%) were diagnosed HIV+ during their current or previous prenatal care. There were 60 HIV+ participants who were currently sexually active (83%). All (59; 81%), except one, reported being in a long-term relationship. Of them, 14 (23%) had a partner with unknown HIV status and 27 (45%) said they knew that their partner(s) were HIV+. Always using a condom with all sexual partners was reported by 29 (48%) women and 39 (65%) reported using a condom during their last sexual intercourse. Most women (50; 81.3%) reported that their HIV diagnosis had had negative effects on their sexual lives (e.g., worries about transmission), although sero-discordance did not predict condom use. Consistent current condom use was least likely among those who reported sexual debut before age 15 (aOR=3.99, p=0.02).
Conclusions: Prenatal settings provide opportunities to promote condom use, although consistent use remains a challenge for many HIV+ pregnant women. Message fatigue and/or lack of empowerment may pose barriers. Prenatal interventions that also target fathers/partners could be helpful.
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