Title:	Influence of culture on contraceptive utilization among HIV-positive women in Brazil, Kenya, and South Africa
Authors:	Todd, Catherine S. Stibich, Mark A. Laher, Fatima Malta, Monica Siqueira Bastos, Francisco Inácio Pinkusfeld Monteiro Imbuki, Kennedy Shaffer, Douglas N. Sinei, Samuel K. Gray, Glenda E.
Affilliation:	Columbia University. Department of Obstetrics and Gynecology. New York, NY, USA Lacuna Projects. Houston, TX, USA University of Witwatersrand. Perinatal HIV Research Unit. Soweto, South Africa Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Ciências Sociais. Rio de Janeiro, RJ, Brasil Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil Fulbright/Capes Visiting Scholar, Brown University, Providence, RI, USA Walter Reed Project. Kericho, Kenya Walter Reed Project. Kericho, Kenya Walter Reed Project. Kericho, Kenya University of Witwatersrand. Perinatal HIV Research Unit. Soweto, South Africa
Abstract:	Contraceptive choice and discontinuation are poorly understood among HIV-positive women, and HIV disease and culture may influence decisions. We assessed factors influencing contraceptive decision-making among HIV-positive women in three countries. This qualitative assessment of 108 HIV-positive women (36/site, selected by age and parity strata) was conducted in Rio de Janeiro, Brazil; Kericho, Kenya; and Soweto, South Africa. Freelist interviews assessed knowledge and attitudes towards contraception and were analyzed enumerating frequency and saliency of mentions. There was intersite consensus around list items but priority and themes varied. Site-specific factors influencing contraceptive choice were male partner wishes and fertility desire (Brazil), side-effects (South Africa), and impact on health and HIV progression (Kenya). Age, parity, and taking antiretroviral therapy (ART) impacted some themes. Contraceptive use among HIV-positive women is substantially influenced by culture and other factors. Counseling efforts should consider individual factors in method selection and offer method variety to accommodate changing needs.
Keywords:	HIV Fertility Desire Contraception Menstruation Future Fertility Condom Use
keywords:	HIV Desejo de Fertilidade Contracepção Menstruação Fertilidade Futura Uso de Preservativo
DeCS:	HIV Fertilidade Anticoncepção Menstruação
Issue Date:	2011
Citation:	TODD, C. S., et al. Influence of culture on contraceptive utilization among HIV-positive women in Brazil, Kenya, and South África. AIDS and Behavior, v.15, n.2, p.454-468, 2011.
DOI:	10.1007/s10461-010-9848-z
ISSN:	1090-7165
Copyright:	open access
Appears in Collections:	ENSP - Artigos de Periódicos ICICT - Artigos de Periódicos

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