Dual Protection among Women Living with HIV/AIDS (WLWHA) in Brazil: Examining contextual factors

Access to antiretroviral treatment and Nevirapine to prevent mother-to-child-transmission has changed the meaning of living with HIV and fertility. Dual protection against unplanned pregnancy and STI/HIV transmission is emerging as a useful prevention strategy in the fields of family planning and HIV/AIDS. However little is known about the use of dual protection among WLWHA. This study examines the relationship between fertility desires, partner sero-concordance, region-specific health care factors, and types of dual protection among WLWHA in Brazil.

Data are from a convenience sample (N=1,177) of sexually active WLWHA of reproductive age who sought services at HIV/AIDS Reference and Training Centers in 2003 and 2004 in all five regions of Brazil. Self-reported data were collected on relationship characteristics, fertility desires, access to health care, quality of care, condom use, and contraceptive use. These data were merged with regional indicators of economic development and health care infrastructure. We use logistic regression to examine the effects of individual and regional factors on dual protection using two models. First, we compare WLWHA who use dual protection to those who do not. Second, among WLWHA who use dual protection, we compare WLWHA by specific dual protection behaviors (e.g. reversible method, irreversible method, or only condoms).

This presentation will explain and discuss dual protection behavior among WLWHA in Brazil. Findings emphasize the importance of considering regional variation in social context, economic development, and investment in health care infrastructure in promoting dual protection strategies.