Trajetórias De Mulheres Vivendo Com Hiv/aids No Brasil. Avanços E Permanências Da Resposta à Epidemia

This article analyzes the trajectories of 85 women living with HIV/AIDS in six Brazilian cities: Belém, São Paulo, Ribeirão Preto, Goiânia, Recife and Pelotas, to understand some specific aspects of their experiences before and after diagnosis. It is based on in-depth interviews conducted in 2009 addressing women diagnosed with HIV between 1 and 20 years previously. The results show a profile characterized by limited access to school, health services and labor and a marked presence of violence. The reasons for applying HIV tests vary over time and there is an increase in prenatal testing, although no modifications in the context of the infection are apparent. For some women, the diagnosis determines changes in lifestyle. However, for the majority, social and labor experiences and the decisions about love, sexuality and reproduction seem to respond to their immediate demands and opportunities. The management of the diagnosis and the support received influence living with HIV/AIDS. These results show the need for actions for prevention and testing not restricted to pregnant women, even in the context of a concentrated epidemic. Studies adopting a biographical perspective can contribute to prevent or improve living with HIV/AIDS appropriate to the different moments of the womens’ trajectories. © 2017, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.221879

Exploring The Relationship Between Induced Abortion And Hiv Infection In Brazil

The impact of HIV on the decision to interrupt pregnancy remains an understudied topic in Brazil and the world. The technical means to implement HIV prevention and treatment interventions are widely available in Brazil. Although Brazil has restrictive abortion laws, induced abortion occurs frequently. This qualitative study investigates the extent to which Brazilian women are motivated to seek abortion as a consequence of having HIV disease, and the extent to which the decision is part of a larger reproductive decision-making context. Researchers interviewed 30 women who were living with HIV and had terminated pregnancies or attempted to do so. Many women identified their HIV status as an important aspect of their decision-making regarding abortion. Women also took into account issues such as the stage of life when the pregnancy occurred and the absence of support from partners and families. Contraceptive practices, pregnancy and abortion in this population are influenced by multiple factors that act on the structural, social, interpersonal and individual levels. We hypothesize that HIV infection and abortion are sometimes associated with similar contexts of vulnerability. Health services therefore should address HIV and reproductive issues together, with reproductive and sexual rights serving as the fundamental basis of health care. © 2012 Reproductive Health Matters.20SUPPL. 398089Political declaration on HIV/AIDS: intensifying our efforts to eliminate HIV/AIDS. 10 June 2011, , http://www.unaids.org/en/media/unaids/contentassets/documents/document/2011/06/20110610_UN_A-RES-65-277_en.pdf, United Nations General Assembly, At:, Accessed 19 January 2011Rates of mother-to-child transmission and the impact of different PMTCT regimens: report of a consultation organised by the UNAIDS Reference Group for Estimates, Modelling and Projections, February-March 2005, , http://www.epidem.org/Publications/PMTCT%20report.pdf, UNAIDS, At:, Accessed 20 October 2011Corrêa, S., Petchesky, R., Reproductive and sexual rights: a feminist perspective (1994) Population policies reconsidered: health, empowerment, and rights, , Harvard University Press, Boston, G. Sen, A. Germain, L.C. Chen (Eds.)The pregnancy intentions of HIV-positive women: forwarding the research agenda [conference report] (2010), March 17-19Harvard School of Public Health, Boston, MAAvila, M.B., Sexual and reproductive rights: challenges for health policies (2003) Cadernos de Saúde Pública, 19 (SUPPL 2), pp. S465-S469Orner, P.J., Bruyn, M., Barbosa, R.M., Access to safe abortion: building choices for women living with HIV and AIDS (2011) Journal of the International AIDS Society, 14, p. 54Barbosa, R.M., Direitos reprodutivos e a transmissão vertical do HIV: 5 anos depois (2009) 1th Encontro Paulista de Prevenção e Controle de DST/AIDS, pp. 19-23. , Coordenação Estadual de DST/AIDS, São PauloJohnson, K.B., Akwara, P., Rutstein, S.O., Fertility preferences and the need for contraception among women living with HIV: the basis for a joint action agenda (2009) AIDS, 23 (SUPPL 1), pp. S7-S17Friedman, R.K., Bastos, F.I., Leite, I.C., Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil (2011) Revista de Saúde Pública, 45 (2), pp. 373-381Stephenson, J.M., Griffioen, A., The effect of HIV diagnosis on reproductive experience. Study group for the Medical Research Council Collaborative Study of Women with HIV (1996) AIDS, 10 (14), pp. 1683-1687Thackway, S.V., Furner, V., Mijch, A., Fertility and reproductive choice in women with HIV-1 infection (1997) AIDS, 11 (5), p. 663Van Benthem, B.H., de Vincenzi, I., Delmas, M.C., Pregnancies before and after HIV diagnosis in a European cohort of HIV-infected women. European Study on the Natural History of HIV Infection in Women (2000) AIDS, 14 (14), pp. 2171-2178Pivnick, A., Loss and regeneration: influences on the reproductive decisions of HIV-positive, drug-using women (1994) Medical Anthropology, 16 (1), pp. 39-62Kline, A., Strickler, J., Kempf, J., Factors associated with pregnancy and pregnancy resolution in HIV-seropositive women (1995) Social Science and Medicine, 40 (11), p. 1535Ingram, D., Hutchinson, S.A., Double binds and the reproductive and mothering experiences of HIV-positive women (2000) Qualitative Health Research, 10 (1), pp. 117-132Kirshenbaum, S.B., Hirky, A.E., Correale, J., "Throwing the dice": pregnancy decision-making among HIV-positive women in four US cities (2004) Perspectives on Sexual and Reproductive Health, 36 (3), pp. 106-113Brasil. Ministério da Saúde (2010) Departamento Nacional de DST, , Aids e Hepatites Virais. Bol. Epidemiol. Preliminar AIDS ;Ano VIIFonseca, M.G., Travassos, C., Bastos, F.I., Distribuição social da AIDS no Brasil, segundo participação no mercado de trabalho, ocupação e status sócio-econÔmico dos casos de 1987 a 1998 (2003) Cadernos de Saúde Pública, 19 (5), pp. 1351-1363Barbosa, R.M., Negociação sexual ou sexo negociado? Poder, gênero e sexualidade em tempos de Aids (1999) Sexualidade pelo avesso: direitos, identidades e poder, pp. 73-88. , Editora 34, São Paulo, R. Parker, R.M. Barbosa (Eds.)Paiva, V., Latorre, M.R., Gravato, N., Sexuality of women living with HIV in São Paulo (2002) Cadernos de Saúde Pública, 18 (6), pp. 1609-1620Diniz, D.E., Medeiros, M., Aborto no Brasil: uma pesquisa domiciliar com a técnica de urna (2010) Ciência & Saúde Coletiva, 15 (SUPPL 1), pp. 959-966Ministério da Saúde, Brasil (2009), Aborto e saúde pública no BrasilMenezes, G.M.S., Aquino, E.M.L., Pesquisa sobre o aborto no Brasil: avanços e desafios para o campo da saúde coletiva (2009) Aborto no Brasil e países do Cone Sul: panorama da situação e dos estudos acadêmicos, , Nepo/Unicamp, Campinas, M.I. Baltar, R.M. Barbosa (Eds.)Faúndes, A., Barzelatto, J., (2004) O drama do aborto, , Editora Komedi, CampinasSantos, N.J.S., Barbosa, R.M., Pinho, A.A., Contextos de vulnerabilidade para o HIV entre mulheres brasileiras (2009) Cadernos de Saúde Pública, 25 (SUPPL 2), pp. S321-S333Barbosa, R.M., Pinho, A., Santos, N.J.S., Aborto induzido entre mulheres em idade reprodutiva vivendo e não vivendo com HIV/Aids no Brasil (2009) Ciência & Saúde Coletiva, 14, pp. 795-807Bajos, N., Marquet, J., Research on HIV sexual risk: social relations-based approach in a cross-cultural perspective (2000) Social Science and Medicine, 50 (11), pp. 1533-1546Olinto, M.T.A., Moreira-Filho, D.C., Fatores de risco e preditores para o aborto induzido: estudo de base populacional (2006) Cadernos de Saúde Pública, 22 (2), pp. 365-375Desclaux, A., Msellati, P., Walentowitz, S., Women, mothers and HIV care in resource-poor settings (2009) Social Science and Medicine, 69 (6), pp. 803-806Knauth, D., Maternidade sob o signo da Aids: um estudo de mulheres infectadas (1997) Direitos tardios: saúde, sexualidade e reprodução na América Latina, pp. 39-64. , PRODIR/FCC, Ed.34, São Paulo, A.O. 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Contexts Of Hiv Vulnerability Among Brazilian Women [contextos De Vulnerabilidade Para O Hiv Entre Mulheres Brasileiras]

This article aims to identify contexts of vulnerability related to HIV among Brazilian women. From November 2003 to December 2004, a crosssectional study was conducted in 13 municipalities in the five Brazilian regions. The study included 1,777 women with a positive HIV diagnosis and 2,045 women attending public health care services. There were no significant differences between the two groups concerning number of sexual partners. However, HIV-positive women had a history of earlier sexual initiation and lower frequency of condom use. Higher proportions of HIV-positive women had used drugs, had a history of previous STDs, and had been victims of sexual violence some time in their life. The findings suggest the importance of considering strategies for HIV prevention focused on women's empowerment as a whole, and not focused only on their individual behaviors.25SUPP 2S321S333Boletim Epidemiológico De Dst E Aids 2007/2008, , Ministério da Saúde, ano V, no. 1Santos, N.J.S., Tayra, A., Silva, S.R., Buchalla, C.M., Laurenti, R., A AIDS no Estado de São Paulo. As mudanças no perfil da epidemia e perspectivas da vigilância epidemiológica (2002) Rev Bras Epidemiol, 5, pp. 286-310Plummer, F.A., Moses, S., Ndinya-Achola, J.O., Factors affecting female-to-male transmission of HIV-1: Implications of transmission dynamics for prevention (1991) Aids and Women's Reproductive Health, pp. 3-45. , In: Chen LC, Amor JS, Segal SJ, editors, New York: Plenum PressDowns, A.M., de Vicenzi, I., Probability of heterosexual transmission of HIV: Relationship to the number of unprotected sexual contacts. European Study Group in Heterosexual Transmission of HIV (1996) J Acquir Immune Defic Syndr Hum Retrovirol, 11, pp. 388-95Ronald, A.R., Slowing heterosexual HIV transmission (1995) Infect Dis Clin North Am, 9, pp. 287-96Giffin, K., Beyond empowerment: Heterosexualities and the prevention of AIDS (1998) Soc Sci Med, 46, pp. 151-6Vermelho, L., Women With Aids: Transmission and Prevention Strategies (1998) Proceedings of The 12spi_supthspii_sup World Aids Conference, pp. 440-1. , Geneva: United Nations Joint Programme on HIV/AIDSVillela, W., O impacto social e econômico do HIV/AIDS no Brasil (2005) Os Novos Desafios Da Responsabilidade Política, pp. 79-95. , In: Pitanguy J, Mota A, organizadoras, Rio de Janeiro: Cidadania, Estudo, Pesquisa, Informação e Ação, (Cadernos Fórum Civil, ano 7, no. 6)Barbosa, R.H.S., AIDS e saúde reprodutiva: Novos desafios (1999) Questões De Saúde Reprodutiva, pp. 281-96. , In: Giffin K, Costa SH, organizadores, Rio de Janeiro: Editora FiocruzBajos, N., Lamarche-Vadel, A., Gilbert, F., Ferrand, M., Moreau, C., Bouyer, J., Contraception at the time of abortion: High-risk time or high-risk women? (2006) Hum Reprod, 21, pp. 2862-7Tran, T.T., Mulhall, B.P., Macaskill, P., Nguyen, T.Q., Risk factors for HIV infection in a gynaeco-obstetric population in Vietnam: A case control study (2005) Sex Health, 2, pp. 71-5Wyatt, G.E., Myers, H.F., Williams, J.K., Kitchen, C.R., Loeb, T., Carmona, J.V., Et al., Does a history of trauma contribute to HIV risk for women of colour? Implications for prevention and policy (2002) Am J Public Health, 92, pp. 660-5Bates, I., Fenton, C., Gruber, J., Lalloo, D., Lara, A.M., Squire, S.B., Vulnerability to malaria, tuberculosis and HIV/AIDS infection and disease. Part 1: Determinants operating at individual and household level (2004) Lancet Infect Dis, 4, pp. 267-77Silveira, M.F., Santos, I.S., Victora, C.G., Poverty, skin colour and HIV infection: A case-control study from southern Brazil (2008) Aids Care, 20, pp. 267-72Braga, P.E., Cardoso, M.R.A., Segurado, A.C., Diferenças de gênero ao acolhimento de pessoas vivendo com HIV em serviço universitário de referência de São Paulo, Brasil (2007) Cad Saúde Pública, 23, pp. 2653-62Filipe, E.M.V., Bugamelli, L., Leme, B., Santos, N.J.S., Garcia, S., Paiva, V., Risk perception and counseling among HIV-positive women in São Paulo, Brazil (2000) Int J Std Aids, 11, pp. 112-4Filipe, E.M.V., Batistella, E., Pine, A., Santos, N.J.S., Paiva, V., Segurado, A., Sexual orientation, use of drugs and risk perception among HIV-positive men in São Paulo, Brazil (2005) Int J Std Aids, 16, pp. 56-60Barbosa, R.M., (1997) Negociação Sexual E Sexo Negociado, Sexualidade E Gênero Em Tempos De Aids [tese De Doutorado], , Rio de Janeiro: Universidade Federal do Rio de JaneiroNascimento, A.M.G., Barbosa, C.S., Medrado, B., Mulheres em Camaragibe: Representação social sobre a vulnerabilidade feminina em tempos de AIDS (2005) Rev Bras Saúde Matern Infant, 5, pp. 77-86Barbosa, R.M., Koyama, M.A.H., Comportamento e práticas sexuais de homens e mulheres, Brasil 1998 e 2005 (2008) Rev Saúde Pública, 42, pp. 21-33(2003) Atitudes Frente Ao Crescimento Da Aids No Brasil, , Instituto Patrícia Galvão, São Paulo: Instituto Patrícia GalvãoSantos, N.J.S., Buchalla, C.M., Filipe, E.M.V., Bugamelli, L., Garcia, S., Paiva, V., Mulheres HIV positivas, reprodução e sexualidade (2002) Rev Saúde Pública, 36, pp. 12-23The global HIV and AIDS epidemic, 2001 (2001) Mmwr Morb Mortal Wkly Rep, 50, pp. 434-9. , Centers for Disease Control and PreventionVillela, W., Mulher, violência e AIDS: Explorando interfaces (2008) Mulher, Violência E Aids. Recife: Gestos - Soropositividade, Comunicação & Gênero, pp. 107-26. , In: Nilo A, organizadorArilha, M., Homens, saúde reprodutiva e gênero: O desafio da inclusão (1999) Questões De Saúde Reprodutiva, pp. 455-67. , In: Giffin K, Costa SH, organizadores, Rio de Janeiro: Editora FiocruzKippax, S., Noble, J., Prestage, G., Crawford, J.M., Campbell, D., Baxter, D., Sexual negotiation in the AIDS era: Negotiated safety revisited (1997) Aids, 11, pp. 191-7Barbosa, R.M., HIV/AIDS, transmissão heterosexual e métodos de prevenção controlados pelas mulheres (2001) Rio De Janeiro: Associação Brasileira Interdisciplinar De Aids, , (Coleção ABIA. Saúde Sexual e Reprodutiva, 2)(2003) Políticas E Diretrizes De Prevenção Das Dst/aids Entre Mulheres, , Coordenação Nacional de DST/AIDS, Secretaria de Programas de Saúde, Ministério da Saúde, Brasília: Ministério da Saúd