205222 Dual Protection among Women Living with HIV/AIDS (WLWHA) in Brazil: Examining contextual factors

Monday, November 9, 2009

Kiyomi Tsuyuki, MPH , Community Health Sciences, University of California, Los Angeles, Los Angeles, CA
Regina Maria Barbosa, MD , University of Campinas (UNICAMP), Brazil, Campinas, Brazil
Adriana A. Pinho , Oswaldo Cruz Foundation/Brazil, Oswaldo Cruz Foundation/Brazil, Rio de Janeiro, Brazil
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.

Learning Objectives:
(1) Identify two important factors that predict dual protection behavior among WLWHA in Brazil. (2) Discuss the importance of considering social and regional context in the contraceptive and fertility choices of WLWHA.

Keywords: Contraception, Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student in the Department of Community Health Sciences at the School of Public Health at UCLA. I have an MPH in Public Health and have worked in issues of sexual and reproductive health, HIV/AIDS, and access and quality of care for over 5 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.