Induced abortion scenarios: are they different in the presence of HIV/AIDS?
W. Vieira Villela1, A.P. Portella2, K. Wolffenbuttel3, O. Analice3, J. Cardoso Santos4, A.L. Nauar Pantoja5, R.M. Barbosa6
1UNIFESP, São Paulo, Brazil, 2NEPS/UFPE, São Paulo, Brazil, 3CRT DST/Aids, Health Department of São Paulo, São Paulo, Brazil, 4Private, Ribeirão Preto, São Paulo, Brazil, 5INCRA, Belem, Brazil, 6NEPO/State University of Campinas and CRT DST/Aids, Health Department of São Paulo, São Paulo, Brazil
Background: Studies conducted in countries with varied socioeconomic realities and cultural backgrounds have evaluated the impact HIV diagnosis on reproductive behavior of women living with HIV and AIDS. These studies aimed to identify factors and scenarios related with induced abortion among women living with HIV/Aids (WLHA) in Brazil.
Methods: A mixed methodology study was carried out. From November 2003 to December 2004, a cross-sectional study was conducted in 13 cities in the five Brazilian regions; 1777 WLHA and 2045 women not living with HIV/Aids (WNLHA) were included. In 2009 a qualitative study was conducted in four of those cities: Belém, Recife, São Paulo and Ribeirão Preto. In-depth interviews were applied to 78 WLWA and MAXQDA7 were used to perform the analyses. Data from the qualitative study will be presented.
Results: The women interviewed were between 20 and 45 years and the majority are from low income strata and have low level of education. While cities are socially, culturally and economically distinct, the contexts of vulnerability of the women are very similar: poverty; family violence or in the neighborhood surroundings, sexual violence at some point in life; little access to goods, services and power. For most of the women the decision toward induced abortion has not been determined by HIV, but by their living conditions at the time of pregnancy.
Conclusions: HIV infection does not seem to lead to the practice of abortion or, at least, women do not confer this meaning to their decision. Apparently unplanned pregnancy and subsequent abortion, and HIV infection are related to the lack of control of women's bodies and sexuality. In this sense, the results confirm the findings of the quantitative study; the contexts associated with HIV infection and to reproductive practices and decisions share similarities and should be addressed together by health services.
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