Feelings related to motherhood among women living with HIV in Brazil: a qualitative study

A qualitative study was carried out with 12 HIV-positive women to describe their feelings about motherhood, to learn whether they make plans for the care of their children, and to identify mechanisms of defence they use to face their seropositivity. Motherhood was seen as an essential attribute of women and a reason of living. Breastfeeding was considered a fundamental component of the maternal role. Some women made provisions with their family for the care of their children. Thinking about the possibility of their children becoming orphans made women feel impotent and guilty. Such painful feelings were minimized through mechanisms of defence like compensation, denial, rationalization and projection. Health care professionals should consider that clinical assistance and free distribution of medication are not sufficient to HIV-positive women. These women need continuous support and guidance with respect to their physical, mental and emotional health as well as that of their children.1991095110

Menarche among Brazilian women: memories of experiences

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective: to present women's experiences of menarche and related memories. Design: qualitative study using focus groups for data collection. Setting: the city of Campinas, Sao Paulo state, Brazil. Participants: 64 women aged 21-51 years, experiencing menstrual periods, with former or current sexual activity and no perceived infertility. Methods: eight focus groups were carried out using a semi-structured guideline. Discussions were recorded with participants' consent, and transcribed and revised. Thematic content analysis was carried out using gender relations as the theoretical framework. Findings: menarche was experienced as a passage from childhood to womanhood, associated with belonging to a new group and acquiring a new status in the family. The experiences of menarche were not always welcomed or expected, but were recalled as associated with body changes and awareness of sexual issues. The mother's behaviour and attitudes towards menarche were clearly seen as generators of strong and everlasting impressions, either in a positive or negative way. Memories related to the experience of menarche extended through their life, interfering with their relation with their own body, including their reproductive health. Key conclusions: the way in which menarche is experienced may exert an impact on women's reproductive health, sexuality and lifestyle behaviours. Implications for practice: the acknowledgement of menarche experiences can be useful to guide healthcare providers towards more effective education of girls on sexual and reproductive health issues and better attention to women's needs. (C) 2009 Elsevier Ltd. All rights reserved.272203208Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAEPEX/UnicampFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Menstruation and amenorrhea: opinion of Brazilian women

Contemporary women experience more menstrual cycles than their predecessors, and their menstrual patterns are modified by contraceptives. Amenorrhea is one side effect that has recently been advocated as desirable. This qualitative study investigated Brazilian women's views regarding the suppression of menstruation using hormones. Data were collected through eight focus groups, following a semistructured guideline. Sixty-four women, 21-51 years old, all menstruating regularly and all of whom had already initiated sexual activity and had no perceived infertility participated. Discussions were recorded, transcribed and entered into the computer, using the Ethnograph V 5.0 software to aggregate similar patterns. Thematic content analysis revealed that menstruation and amenorrhea were both seen with ambiguity. Although regarded as a nuisance, menstruation was associated with femaleness, youth, fertility and health. Most women, although they would like to be free from menstruation, feared negative consequences of induced amenorrhea and even regarded the proposition as a male intrusion into what they consider a natural female condition. (c) 2005 Elsevier Inc. All rights reserved.72215716

Delivery of microbicides to the vagina: difficulties reported with the use of three devices, adherence to use and preferences

Purpose: A crossover study was carried out in 405 couples to compare women's difficulties with three different devices that could be used to administer a microbicide and to evaluate adherence to use and preference for any one of the devices. Methods: Couples used a single size diaphragm, a vaginal ring or disposable applicators for 1 month each in a randomly assigned order. Results: Few women reported difficulty using the applicators or the ring; however, almost two-thirds reported difficulty using the diaphragm. Approximately 5%, 10% and 40% of the women and a similar but slightly lower percentage of their partners reported incorrect use of the applicator, vaginal ring and diaphragm, respectively. About half the women preferred the vaginal ring, while around half the men preferred the applicator. Conclusion: The release of microbicides from a vaginal ring is a lead worth pursuing. The diaphragm is the only one of the three devices that also offers mechanical protection, but it requires greater investment in patient education to ensure adherence to use. (C) 2007 Elsevier Inc. All rights reserved.76212613

Women's responses to menses and nonbleeding intervals in the USA, Brazil and Germany

Background: Studies from several countries suggest women differ in their preferred length of nonbleeding intervals, yet studies to date have not explored the social determinants of such preferences. Method: We report results from a menstrual preference and social survey of 1207 healthy women in three age groups (18-20, 25-34 and 45-49 years) and two educational strata (high and low educational attainment), from Campinas (Brazil), Heidelberg (Germany) and Ann Arbor (USA) (similar to 400 women from each country). Results: Women's preferred length of nonbleeding intervals differed significantly between countries. In Ann Arbor, only 15.5% of women preferred to bleed monthly, vs. 30.2% in Heidelberg. In both Ann Arbor and Campinas, approximately one-third of women preferred to "never" have menses, compared to 8.2% in Heidelberg. Multivariate analyses indicated that country, church attendance, stress and menstrual pain were significant predictors of women's preferences. Conclusion: The most common preference among women was to bleed once every 3 months, but preferences varied substantially by country groups. Preferences for nonbleeding intervals were, in part, explained by personal experiences of stress or menstrual pain, but unexplained cultural differences persist between country groups. (c) 2007 EIsevier Inc. All rights reserved.761232

Dr. FRANZ OPPENHEIMER. Werte und Kapitalprofit. 230 Sider. Gustav Fischer, Jena 1916.

The rapid spread of HIV/AIDS in the female population increases the urgency of developing new formulations that offer protection from this disease as well as other sexually transmitted infections. In many cultures, women do not readily accept touching their genitals or inserting products into their vaginas. Information on this subject was collected during a study involving 635 women in Brazil to determine the preferred attributes of vaginal products. Seventy-six percent would use an idealized contraceptive method that offered dual protection even though it could only be inserted with a finger and 96% would use this method if it could only be placed with an applicator. Qualitative analyses of responses to open questions suggest that the majority of Brazilian women studied did not like to touch their vagina with their finger or to insert devices. Although the introduction of safe and effective vaginal microbicides into many cultural settings can be successful, it should be accompanied by significant efforts to educate women about their bodies. (C) 2003 Elsevier Inc. All rights reserved.67539139

Association between characteristics of current menses and preference for induced amenorrhea

Background: Several studies suggest that many women would prefer to avoid menses altogether, but few studies have examined the social or clinical predictors of such preference. Study Design: In total, 1224 healthy women of reproductive age were surveyed in Brazil, Germany and the United States regarding social, menstrual and reproductive characteristics and preferences for various dimensions of menstruation, including the ideal interval between menses. The extent to which a preference to never bleed was predicted by current experiences with menses was evaluated. Results: Long menses, menstrual pain and a perceived high cost of pads and tampons were predictive of preferring amenorrhea over all other menstrual patterns after controlling for age, parity and education. Independent significant associations were also found with increasing degrees of life stress and ever use of injectable contraceptives. Conclusion: A negative experience with menstruation, a high ranking of life stress and ever use of injectable contraception were independently associated with a preference to avoid menses altogether. (C) 2009 Elsevier Inc. All rights reserved.80326626

Women and AIDS: gender relations and condom use with steady partners Mulheres e AIDS: relações de gênero e uso do condom com parceiro estável

An educational project on sexuality, STDs, and AIDS was conducted for four years with some 500 women. As a result, changes were observed in HIV-related knowledge and attitudes, but not in risk behaviors for infection. This fact motivated the development of a qualitative study to learn the reasons why women failed to incorporate HIV preventive behaviors into their daily lives. Six focus groups were conducted with women who had participated in the educational project. The analysis was thematic. Women were familiar with HIV transmission routes and preventive measures. They admitted not using condoms due to fear of being suspected of infidelity and because this might lead to separation of the couple. Women reported that relationships with their partners had been difficult because of lack of dialogue and that men always had the final word. Although women had information about AIDS, they did not use preventive measures in steady relationships because they did not wield decision-making power. Gender inequality and fidelity were two significant issues related to the increase in AIDS among women.<br>Um projeto educativo sobre sexualidade, DST e AIDS foi realizado durante quatro anos com cerca de quinhentas mulheres. Como resultado, houve mudanças em conhecimentos e atitudes em relação ao HIV, mas não em comportamentos de risco para a infecção. Isto motivou a realização de um estudo qualitativo para conhecer as razões pelas quais as medidas de prevenção de AIDS não são incorporadas ao cotidiano das mulheres. Foram realizados seis grupos focais com mulheres que haviam participado do projeto educativo citado. A análise foi temática. As mulheres citaram todas as vias de transmissão e prevenção de AIDS. Reconheceram que não usavam condom porque tinham medo de despertar suspeita de infidelidade e provocar a separação do casal. Relataram que a relação a dois era difícil por falta de diálogo e que a palavra final era sempre do homem. Apesar das mulheres terem informação e conhecerem os riscos, não usavam medidas preventivas em relacionamento estável porque não tinham poder de decisão. Relações desiguais de gênero e questões relacionadas à fidelidade foram apontadas como fatores que contribuem para a disseminação do HIV nas mulheres