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Ajayi AI, Ahinkorah BO, Seidu AA, Adeniyi OV. Prevalence and correlates of induced abortion: results of a facility-based cross-sectional survey of parturient women living with HIV in South Africa. Reprod Health 2022; 19:220. [PMID: 36471337 PMCID: PMC9721078 DOI: 10.1186/s12978-022-01520-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/01/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND There is a paucity of studies examining the prevalence and correlates of induced abortion among women living with HIV. Our study fills this gap by examining the prevalence and correlates of induced abortion among parturient women living with HIV in Eastern Cape, South Africa. METHODS We analysed cross-sectional survey data of the East London Prospective Cohort Study, which took place between September 2015 and May 2016 in three large maternity facilities in the Buffalo/Amathole districts of the Eastern Cape Province of South Africa. A total of 1709 parturient women living with HIV who gave birth over the study period were recruited. We carried out descriptive and inferential statistics. RESULTS The prevalence of induced abortion was 19% (95% CI: 17.2-20.9%), but varied by women's socio-demographic characteristics. Induced abortion prevalence was higher among women aged 25 years and over (21.4%), than among women aged less than 25 years (11.0%). Those ever married or cohabiting (26.8%) reported a higher level of induced abortion than those never-married women (15.6%). Those already diagnosed HIV positive before their index pregnancy (20.2%) had a higher prevalence of induced abortion than those diagnosed during their index pregnancy (14.1%). In the adjusted logistic regression, women were more likely to have ever induced abortion if they were ever married or cohabiting (aOR; 1.86 95% CI; 1.43-2.41), ever smoked (aOR: 1.51; 95% CI: 1.01-2.28) and diagnosed with HIV before their index pregnancy (aOR:1.44; 95% CI: 1.02-2.05) but less likely if younger than 25 years (aOR; 0.51 95% CI:0.35-0.73). CONCLUSION About one in five women living with HIV had ever induced abortion in the study settings, indicating that abortion service is one of the main reproductive health services needed by women living with HIV in South Africa. This is an indication that the need for abortion is somewhat high in this group of women. The finding, therefore, highlights the need for concerted efforts from all stakeholders to address the unmet need for contraception among women living with HIV to prevent unintended pregnancy.
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Affiliation(s)
- Anthony Idowu Ajayi
- grid.413355.50000 0001 2221 4219Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, APHRC Campus, Manga Close, Nairobi, Kenya
| | - Bright Opoku Ahinkorah
- grid.117476.20000 0004 1936 7611School of Public Health, Faculty of Health, University of Technology, Sydney, Australia
| | - Abdul-Aziz Seidu
- grid.511546.20000 0004 0424 5478Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana ,grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD Australia
| | - Oladele Vincent Adeniyi
- grid.412870.80000 0001 0447 7939Department of Family Medicine, East London Hospital Complex, Walter Sisulu University/Cecilia Makiwane Hospital, East London, South Africa
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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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de Brito ES, Knauth DR, Brand ÉM, Calvo KDS, Vigo Á, Pilecco FB, Machado FV, de Teixeira MA, de Almeida FM, Hentges B, Silva DL, Teixeira LB. Factors Associated with HIV and Vulnerability Contexts for Women in Brazil. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3247-3256. [PMID: 33864176 DOI: 10.1007/s10508-021-01960-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 01/31/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to identify factors associated with HIV and vulnerability contexts for women in Porto Alegre, Brazil. The participants were 1326 women recruited by complex sampling design, divided into two groups: 640 women with HIV (WLH) and 686 women who did not have HIV (WNLH). Gross and weighted statistical analyses were performed. Logistic regression models were used to estimate the odds ratio (OR) for 12 variables. The main results demonstrated that WLH had lower income (p < .001) and poorer education (p = .038), and few used condoms during their first sexual intercourse (p < .001). The occurrence of HIV was higher among the black population (p < .001). Sex in exchange for money (p < .001) and sexually transmitted infections (p < .001) were more frequent among WLH than among WNLH. The age of sexual debut and age difference from the partner at first sexual intercourse (FSI) were not associated with the outcome. The high percentage of non-use of condoms during the FSI shows how vulnerable individuals are right at the beginning of their sexual lives. More effective prevention strategies can be developed by nurses in view of the contexts of vulnerability surrounding women.
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Affiliation(s)
- Emerson Silveira de Brito
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
| | - Daniela Riva Knauth
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Évelin Maria Brand
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
| | - Karen da Silva Calvo
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
- School of Nursing, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Álvaro Vigo
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávia Bulegon Pilecco
- Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Frederico Viana Machado
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
| | - Marsam Alves de Teixeira
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
| | - Franciele Moletta de Almeida
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil
| | - Bruna Hentges
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Danielle Lodi Silva
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana Barcellos Teixeira
- Department of Collective Health, School of Nursing, Federal University of Rio Grande do Sul, 90620-110, Porto Alegre, Brazil.
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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Zachek CM, Coelho LE, Domingues RMSM, Clark JL, De Boni RB, Luz PM, Friedman RK, de Andrade ÂCV, Veloso VG, Lake JE, Grinsztejn B. The Intersection of HIV, Social Vulnerability, and Reproductive Health: Analysis of Women Living with HIV in Rio de Janeiro, Brazil from 1996 to 2016. AIDS Behav 2019; 23:1541-1551. [PMID: 30652206 PMCID: PMC6536320 DOI: 10.1007/s10461-019-02395-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Comprehensive care for sexual and reproductive health (SRH) and social needs for women living with HIV remains limited globally. We aimed to assess trends in baseline sociodemographic, clinical, sexual, and reproductive characteristics among a cohort of HIV-infected women in Rio de Janeiro from 1996 to 2016. Participants were stratified into four time periods based on year of enrollment; we compared cross-sectional data from each period. Of 1361 participants (median age 36), most were black or mixed race (60.1%), unemployed (52.1%), and without secondary education (54%). Adolescent pregnancy was common (51.5%), and 18.3% reported sexual debut at < 15 years old. Nearly half (45.2%) had < 5 lifetime sexual partners, yet prior syphilis and oncogenic human papillomavirus prevalence were 10.9% and 43.1%, respectively. Lifetime prevalence of induced abortion was 30.3%, and 16% used no contraceptive method. Future research should explore interactions between social vulnerability, HIV, and poor SRH outcomes and healthcare models to alleviate these disparities.
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Affiliation(s)
- Christine M Zachek
- School of Medicine, University of California San Francisco, San Francisco, CA, USA.
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, South American Program in HIV Prevention Research (SAPHIR), Los Angeles, CA, USA.
| | - Lara E Coelho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rosa M S M Domingues
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jesse L Clark
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, South American Program in HIV Prevention Research (SAPHIR), Los Angeles, CA, USA
| | - Raquel B De Boni
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paula M Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ruth K Friedman
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jordan E Lake
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, South American Program in HIV Prevention Research (SAPHIR), Los Angeles, CA, USA
- Department of Medicine, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Rossetto M, Brand ÉM, Teixeira LB, Oliveira DLLCD, Serrant L. THE SILENCES FRAMEWORK: METODOLOGIA PARA PESQUISAS DE TEMAS SENSÍVEIS E PERSPECTIVAS MARGINALIZADAS NA SAÚDE. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072017002910017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: descrever a utilização da metodologia The Silences Framework em uma pesquisa na área da saúde, envolvendo a temática da coinfecção tuberculose/HIV/aids. Método: a metodologia foi originalmente utilizada para estudar decisões e silêncios de homens negros do Caribe que viviam na Inglaterra, problematizando-se os temas ‘saúde sexual’ e ‘etnicidade’ e resultando em uma teoria para a pesquisa de questões sensíveis e de cuidados de saúde de populações marginalizadas. The Silences Framework define áreas de pesquisa e experiências que são pouco estudadas, compreendidas ou silenciadas. Resultados: os “silêncios” podem refletir aspectos não compartilhados sobre como crenças, valores e experiências de alguns grupos influenciam sua saúde. Esse referencial prevê a aplicação de quatro estágios complementares: trabalhando os silêncios, ouvindo os silêncios, dando voz aos silêncios e trabalhando com os silêncios. A análise ocorre de modo cíclico e pode ser repetida enquanto os silêncios não forem desvelados. Conclusão: este artigo apresenta a noção de “sons do silêncio”, mapeando um quadro teórico antiessencialista para sua utilização em pesquisas sensíveis na area da saúde e da enfermagem, podendo ser referência para outros investigadores em estudos envolvendo populações marginalizadas.
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Pinho ADA, Cabral CDS, Barbosa RM. Differences and similarities in women living and not living with HIV: contributions by the GENIH study to sexual and reproductive healthcare. CAD SAUDE PUBLICA 2017; 33:e00057916. [PMID: 29267678 DOI: 10.1590/0102-311x00057916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 03/22/2017] [Indexed: 11/22/2022] Open
Abstract
This quantitative study in the city of São Paulo, Brazil, compared contexts of social vulnerability and sexual and reproductive behavior in a sample of 975 women living with HIV/AIDS (WLHIV) and 1,003 women not living with HIV, the latter recruited among users of the primary healthcare system. WLHIV experienced situations of greater vulnerability that potentially increased their risk of HIV infection and unplanned pregnancy and abortion. Compared to women users of the primary healthcare system, WLHIV reported higher rates of drug use, sex for money, exposure to intimate partner violence, difficulties in access to services for prevention and early diagnosis, unplanned pregnancies, induced abortion, and teenage pregnancy. A considerable number of the women users of the primary healthcare system shared these same experiences, but at lower rates. The identification of contexts of vulnerability and the integration of HIV testing services with sexual and reproductive health services should constitute lines of care for these women, both in specialized and primary care services.
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Affiliation(s)
| | | | - Regina Maria Barbosa
- Núcleo de Estudos de População Elza Berquó, Universidade Estadual de Campinas, Campinas, Brasil
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Saffier IP, Kawa H, Harling G. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil. BMC Infect Dis 2017; 17:675. [PMID: 29020929 PMCID: PMC5637257 DOI: 10.1186/s12879-017-2795-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/04/2017] [Indexed: 11/12/2022] Open
Abstract
Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Results Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Conclusions Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in Brazil.
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Affiliation(s)
| | - Hélia Kawa
- Department of Epidemiology, Fluminense Federal University, Niterói, Brazil
| | - Guy Harling
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK. .,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.
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Teixeira LB, Pilecco FB, Vigo Á, Drachler MDL, Leite JCDC, Knauth DR. Factors associated with post-diagnosis pregnancies in women living with HIV in the south of Brazil. PLoS One 2017; 12:e0172514. [PMID: 28222175 PMCID: PMC5319676 DOI: 10.1371/journal.pone.0172514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/05/2017] [Indexed: 11/19/2022] Open
Abstract
Objectives To analyze the factors associated with the occurrence of pregnancies after the diagnosis of infection by HIV. Methods Cross-sectional study with women of a reproductive age living with HIV/AIDS cared for in the public services of the city of Porto Alegre, in southern Brazil. The data was analyzed from a comparison between two groups: women with and women without pregnancies after the diagnosis of HIV. Poisson regression models were used to estimate the reasons of prevalence (RP). Results The occurrence of pregnancies after the diagnosis of HIV is associated with a lower level of education (RP adjusted = 1.31; IC95%: 1.03–1.66), non-use of condoms in the first sexual intercourse (RP = 1.32; IC95%: 1.02–1.70), being 20 years old or less when diagnosed with HIV (RP = 3.48; IC95%: 2.02–6.01), and experience of violence related to the diagnosis of HIV (RP = 1.28; IC95%: 1.06–1.56). Conclusions The occurrence of pregnancies after the diagnosis of infection by HIV does not indicate the exercise of the reproductive rights of the women living with HIV/AIDS because these pregnancies occurred in contexts of great vulnerability.
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Affiliation(s)
- Luciana Barcellos Teixeira
- Department of Professional Assistance and Guidance, Nursing School, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Studies Program in Public Health, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Flávia Bulegon Pilecco
- Department of Social Medicine, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
| | - Álvaro Vigo
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
- Department of Statistics, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria de Lourdes Drachler
- Graduate Studies Program in Public Health, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Daniela Riva Knauth
- Department of Social Medicine, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil
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Barbosa RM, Cabral CDS, do Lago TDG, Pinho ADA. Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil. PLoS One 2016; 11:e0164887. [PMID: 27812146 PMCID: PMC5094764 DOI: 10.1371/journal.pone.0164887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In many countries, young women of reproductive age have been especially affected by the HIV epidemic, which have fostered research to better understand how HIV infection influences and shapes women´s fertility and reproductive and sexual decisions. In Brazil, few studies have focused on the impact of the HIV epidemic on contraceptive choices among women living with HIV (WLHIV). OBJECTIVE This study evaluates the impact HIV infection may have in the access to female sterilization in Brazil, using a time-to-event analysis. METHODS A cross-sectional quantitative study (GENIH study) was conducted between February 2013 and April 2014 in the city of São Paulo, comparing two probabilistic samples of 975 WLHIV and 1,003 women not living with HIV (WNLHIV) aged 18 to 49. Sexual and reproductive data was collected retrospectively in order to reconstruct women's reproductive trajectories. Given the objectives of this study, the analysis was restricted to women with parity one or more and, in case of WLHIV, to those sterilized after HIV diagnosis and not infected through vertical transmission. The final sample analysis included 683 WNLHIV and 690 WLHIV. A series of multivariable-adjusted Cox models estimated the probability of being sterilized after HIV diagnosis, compared with WNLHIV. Models were adjusted for schooling, race/color, and stratified by parity at last delivery (1-2, 3+). Hazard ratios were calculated for female sterilization, and separately for interval and postpartum procedures (performed in conjunction with caesarean section or immediately after vaginal delivery). Additionally, information regarding unmet demand for female sterilization was also explored. FINDINGS No statistical difference in the overall risk of sterilization between WLHIV and WNLHIV in the two parity-related groups is observed: HR = 0.88 (0.54-1.43) and 0.94 (0.69-1.29), respectively, among women with 1-2 children and those with three and more. However, significant differences regarding the impact of HIV infection at sterilization are observed depending on the timing and the type of sterilization procedure. The probability of obtaining an interval sterilization is significantly lower for WLHIV compared to those not living with HIV. The reverse occurs regarding postpartum sterilization. Although sterilization is mainly performed in conjunction with caesarean section in Brazil, it is evident that caesarean sections are not the sole factor increasing the risk of sterilization among WLHIV. CONCLUSION The results indicate barriers in the access to services offering interval sterilization for WLHIV and certain facilitation in obtaining the procedure in conjunction with caesarean section. Health policy makers at local and national levels should promote institutional changes in order to facilitate access to interval sterilization and to confront the sensitive discussion of WLHIV's eligibility for postpartum sterilization. It is also urgent to increase access to a wider range of contraceptive methods for WLHIV and promote dual method protection strategies. Moreover, since condom use may decrease in the future in the context of the preventive effect of antiretroviral therapy, promoting dual methods will expand the choices regarding the reproductive rights of women living with HIV.
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Affiliation(s)
- Regina Maria Barbosa
- Núcleo de Estudos da População Elza Berquó –Universidade Estadual de Campinas–Campinas, Brazil
- Centro de Referêcia e Treinamento em DST/AIDS–Secretaria de Estado da Saúde de São Paulo–São Paulo, Brazil
| | - Cristiane da Silva Cabral
- Departamento de Saúde Materno-Infantil–Faculdade de Saúde Pública–Universidade de São Paulo–São Paulo, Brazil
| | | | - Adriana de Araujo Pinho
- Laboratório de Educação em Ambiente e Saúde–Instituto Oswaldo Cruz–Fiocruz–Rio de Janeiro, Brazil
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Flores GL, de Almeida AJ, Miguel JC, Cruz HM, Portilho MM, Scalioni LDP, Marques VA, Lewis-Ximenez LL, Lampe E, Villar LM. A Cross Section Study to Determine the Prevalence of Antibodies against HIV Infection among Hepatitis B and C Infected Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030314. [PMID: 26978383 PMCID: PMC4808977 DOI: 10.3390/ijerph13030314] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 12/16/2022]
Abstract
(1) BACKGROUND: There are limited data regarding human immunodeficiency virus (HIV) prevalence among hepatitis B virus (HBV) or hepatitis C virus (HCV) infected individuals. The aim of this cross-sectional study is to determine the prevalence of HBV and HCV infection among HIV individuals; (2) METHODS: A total of 409 patients (126 HBV+ and 283 HCV+) referred to the Brazilian Reference Laboratory for Viral Hepatitis from 2010 to 2013 donated serum samples. Anti-HIV, HBsAg, anti-HBc, anti-HBs, anti-HBcIgM, anti-HBe, HBeAg, and anti-HCV antibodies were measured, and anti-HCV positive samples were tested for viral RNA and genotype; (3) RESULTS: The anti-HIV antibody prevalence was 10.31% and 4.59% among HBV+ and HCV+ patients, respectively. The HCV mean (SD) viral load was log 5.14 ± 1.64 IU/mL, and genotype I was most prevalent (163/283). Anti-HBs and anti-HBc were detected in 40% and 26% of HCV+ individuals, respectively. Among the HBV+ population, the presence of anti-HIV antibodies was associated with male gender, marital status (married), tattoo, sexual orientation, sexual practices (oral sex and anal sex), history of sexually transmitted diseases (STDs), history of viral hepatitis treatment, and a sexual partner with hepatitis or HIV. For the HCV+ group, the presence of anti-HIV antibodies was associated with female gender, marital status (married), anal intercourse, previous history of STDs, and number of sexual partners; (4) CONCLUSION: A high prevalence of anti-HIV antibodies was found among individuals with HBV and HCV, showing the importance of education programmes towards HIV infection among HBV- and HCV-infected individuals.
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Affiliation(s)
- Geane L Flores
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Adilson J de Almeida
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Juliana C Miguel
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Helena M Cruz
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Moyra M Portilho
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Letícia de P Scalioni
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Vanessa A Marques
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Lia Laura Lewis-Ximenez
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Elisabeth Lampe
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
| | - Livia Melo Villar
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 210360-040, Brazil.
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Alvarenga WDA, Galvão MTG, Nascimento LC, Beretta MIR, Dupas G. WEAKENED SOCIAL NETWORK: THE EXPERIENCE OF CAREGIVERS OF THE HIV-EXPOSED INFANT. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-07072015011160014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACTThis study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.
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