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APHA Scientific Session and Event Listing

Improving Client Provider Interaction in Sexual and Reproductive Health Services for HIV Positive Women

Paul M. Perchal, MA, HIV/STI Program, EngenderHealth, 440 Ninth Ave., 13th Floor, New York, NY 10001, Lynn Collins, MD, HIV/AIDS Branch, UNFPA, 220 East 42nd Street, New York, NY 10017, Rasha Dabash, MA, Consultant, 2603 Centinela Ave., Apt. B, Santa Monica, CA 90405, and Wuleta Betemarium, MPH, Programs, EngenderHealth, 440 Ninth Ave., 13 th Floor, New York, NY 10001, 212-561-8386, wbetemarium@engenderhealth.org.

Issues: Counseling HIV positive women is an aspect of care that runs through the spectrum of SRH services. Yet the level of client/provider interaction required is often not understood by providers or simply does not take place, due to unclear guidelines, lack of training, or provider fears and biases. Description: To respond to the SRH needs of HIV positive women EngenderHealth and UNFPA completed a qualitative research study in Brazil, Ethiopia, and the Ukraine in 2005. A total of 11 focus groups and 93 in-depth interviews were conducted with policy influentials, health workers, and HIV positive women and their partners to identify barriers and facilitating factors to use of SRH services by HIV positive women and their partners. Lessons Learned: The data was analyzed using grounded theory and Atlas.ti software. Findings revealed a lack of informed choice and decision-making among HIV positive women regarding their sexuality and fertility. Equally important was the lack of clarity among providers regarding informed consent, HIV disclosure, and partner notification, as well as inadequate skills to address sensitive issues such as sexual desire and pleasure, STI/RTI prevention, couple counseling, and dual protection. Recommendations: To improve the quality of SRH counseling for HIV positive women policy makers and program manages should ensure national family planning, VCT, PMTCT, and treatment and care guidelines clearly address informed consent, HIV disclosure, and partner notification. Health workers should be offered training on counseling skills, HIV-related stigma and discrimination, and rights-based health care.

Learning Objectives: At the end of this session the participants in this session will be able to

Keywords: Counseling, Women and HIV/AIDS

Presenting author's disclosure statement:

Any relevant financial relationships? No

Addressing STIs and HIV Around the World

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA