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Title: Patient–provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil
Authors: Malta, Monica Siqueira
Todd, Catherine S.
Stibich, Mark A.
Garcia, Thais
Pacheco, Diego
Bastos, Francisco Inácio Pinkusfeld Monteiro
Affilliation: Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Columbia University. Department of Obstetrics & Gynecology. New York, NY, USA
Lacuna Consulting. Houston, TX, USA
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil
Abstract: 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.
Keywords: HIV
Reproductive health
Issue Date: 2010
Publisher: Elsevier
Citation: MALTA, M., et al. Patient–provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil. Patient Education and Counseling, v.81, n.3, p. 476–482, 2010.
DOI: 10.1016/j.pec.2010.09.013
ISSN: 0738-3991
Copyright: open access
Appears in Collections:ICICT - Artigos de Periódicos

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