OBJECTIVE: To qualitatively assess the influence of patient-provider communication on contraceptive choice among HIV-positive women in the context of universal antiretroviral therapy (ART) access. METHODS: Focus group discussions (FGD; n=3), in-depth (IDI; n=15) and freelist interviews (FLI; n=36) were conducted with HIV-positive women aged 18-40 years recruited from public health units in Rio de Janeiro/Brazil. RESULTS: Of 70 participants, 49 used ART and the median time since HIV diagnosis was 6 years (range: 1-18). The majority of participants (71.4%) reported some degree of dissatisfaction with their health providers (usually lack of open dialogue) and a few reported experiences of stigma/prejudice during appointments. Intra, interpersonal and social factors modulated behaviors and reproductive health decisions, and those issues were rarely addressed by providers during HIV clinical care. CONCLUSION: Despite dramatic increases in survival and life quality after universal ART implementation in Brazil, reproductive health issues are neglected by multiple cadres of HIV health providers. Communication on reproductive health issues remains fragmented and potentially contradictory, compromising care in these settings. PRACTICE IMPLICATIONS: Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting.
OBJECTIVE: To qualitatively assess the influence of patient-provider communication on contraceptive choice among HIV-positive women in the context of universal antiretroviral therapy (ART) access. METHODS: Focus group discussions (FGD; n=3), in-depth (IDI; n=15) and freelist interviews (FLI; n=36) were conducted with HIV-positive women aged 18-40 years recruited from public health units in Rio de Janeiro/Brazil. RESULTS: Of 70 participants, 49 used ART and the median time since HIV diagnosis was 6 years (range: 1-18). The majority of participants (71.4%) reported some degree of dissatisfaction with their health providers (usually lack of open dialogue) and a few reported experiences of stigma/prejudice during appointments. Intra, interpersonal and social factors modulated behaviors and reproductive health decisions, and those issues were rarely addressed by providers during HIV clinical care. CONCLUSION: Despite dramatic increases in survival and life quality after universal ART implementation in Brazil, reproductive health issues are neglected by multiple cadres of HIV health providers. Communication on reproductive health issues remains fragmented and potentially contradictory, compromising care in these settings. PRACTICE IMPLICATIONS: Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting.
Authors: Kiyomi Tsuyuki; Jessica D Gipson; Lianne A Urada; Regina Maria Barbosa; Donald E Morisky Journal: J Fam Plann Reprod Health Care Date: 2016-02-15
Authors: Wei-Ti Chen; Dean Wantland; Paula Reid; Inge B Corless; Lucille S Eller; Scholastika Iipinge; William L Holzemer; Kathleen Nokes; Elizbeth Sefcik; Marta Rivero-Mendez; Joachim Voss; Patrice Nicholas; J Craig Phillips; John M Brion; Caro Dawson Rose; Carmen J Portillo; Kenn Kirksey; Kathleen M Sullivan; Mallory O Johnson; Lynda Tyer-Viola; Allison R Webel Journal: J AIDS Clin Res Date: 2013-11-01
Authors: Megan K Ramaiya; Elizabeth Haight; Jane M Simoni; Jean Marcxime Chéry; Witson Dervis; Wilner Genna; Jean Géto Dubé; Guirlène Calixte; Jean Gabriel Balan; Jean Guy Honoré; Nancy Puttkammer Journal: J Int Assoc Provid AIDS Care Date: 2020 Jan-Dec