Acknowledging women's sexual and reproductive rights: a key to the provision of more integrated and effective health care in the metropolitan area of Buenos Aires, Argentina
M.L. Gogna1, H. Manzelli2, S. Fernández1
1CEDES, Health, Economy and Society, Ciudad Autónoma de Buenos Aires, Argentina, 2CENEP, Ciudad Autónoma de Buenos Aires, Argentina
Background: Understanding the experiences, decisions and practices of women with HIV infection regarding contraception, pregnancy and motherhood provides insights to increase the sensitivity and efficiency of health care and promote services´ integration.
Methods: The research design includes triangulation of quantitative and qualitative techniques. Descriptive quantitative analysis is based on a survey of 169 women attending the National Referral Aids Center (CNRS) in 2009. Qualitative analysis is based on 17 semi-structured interviews with women taking their babies to be tested for HIV to CNRS (2010).
Results: Quantitative data indicates that 55% of interviewees do not want a (new) pregnancy and 42% -mostly the younger- would like to have children in the future. In the last sexual encounter, 80.5 % of sexually active women who risk a pregnancy used a method to avoid it. 74% used condoms exclusively, 9.1% used condoms plus another contraceptive (double protection) and 16% a method other than condoms (mostly, the pill).Only 55% of women visit a gynecologist. 29% of interviewees reported having addressed contraception or reproductive intentions with health professionals (mainly, infectious disease specialists). 12% of the 129 women who had heard about the “morning after pill” got this information from a health care provider (the media, friends and relatives were the main source of information). Qualitative data reveals that motherhood is frequently sought or welcomed and that it gives women strength to cope with the infection and/or adverse circumstances in their lives.
Conclusions: HIV infection is part of women's lives and does not have a unique impact on sexual and reproductive behavior. Acknowledging women's needs and agency in this area is crucial to deliver more integrated health services while contributing to the fulfillment of their sexual and reproductive rights. Infectious disease specialists need to encourage women to visit a gynecologist, promote “double protection” and provide information on emergency contraception.
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