Abstract

Negative changes in sexual life of HIV-positive women and its associations, Brazil

L. Polistchuck¹, I. Franca-Junior², V. Paiva³, J.R. Ayres<sup>4

1</sup>School of Public Health - USP, São Paulo, Brazil, ²School of Public Health - USP, Dept of Maternal and Child Health, Sao Paulo, Brazil, ³Instituto de Psicologia - USP, São Paulo, Brazil, ⁴School of Medicine/University of Sao Paulo, São Paulo, Brazil

Background: After 30 years of epidemic, sexuality of HIV-positive women remains taboo. In Brazil, where we have the right of HAART treatment, few studies analyzed those women sexual life.
Methods: In a consecutive sample, 729 HIV positive women of two specialized AIDS care centers in Sao Paulo were interviewed amid 1999 and 2000. The inclusion criteria was having at least 18 years old. Four out of ten women reported negative changes and one in ten interrupted their sexual life after HIV diagnosis. Associated factors (adjusted prevalence ratios - PR) were estimated by Poisson regression.
Results: Negative changes in sexual life after diagnosis were associated with four variables: not using condom to avoid children after diagnosis (PR:1,45), not being attended by a gynecologist in the health care center (PR: 1.20), not being attended by a nurse in the health care center (PR: 1.22), as well as experiencing physical discomfort in health care (RP 2.37). Protective variables for negative changes were: having a steady partner (RP: 0.75), at least two sexual partnership through life (RP: 0.68), income of 2 to 5 monthly minimum wages (RP: 0.74).
Conclusions: Compared to other study on HIV positive women (Bova and Durante, 2003), the interruption of sexual life after diagnosis among women is similar. However, here women indicate a higher proportion of sexual life worsening after diagnosis (40% vs 11%). The associations found in the present study indicate that improving the bonding with health care services may affect HIV positive women perception of their sexual lives. Having an income on the extremes (too low or too high) seems to favour sexual life worsening. These associations demonstrate sexual life goes through multifaceted influences. These factors should be observed if we aim at guaranteeing the right to a healthy, satisfactory, pleasurable and free of coercion sex life; with or without HIV.