AEGiS-14IAC: Reproductive choices and the impact of the medical culture on female sterilization rates among HIV-positive pregnant women in Brazil.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Reproductive choices and the impact of the medical culture on female sterilization rates among HIV-positive pregnant women in Brazil.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrE1068)

Barbosa RM, Knauth DR, Hopkins K, Potter JE
Center for Population Studies/University of Campinas, Campinas, Brazil

BACKGROUND: The reproductive rights and choices of HIV positive women are a global public health concern. The HIV/AIDS epidemic in Brazil mirrors international trends as HIV infection among women of reproductive age continues to rise. Though little is known about the contraceptive experiences of HIV-positive women, the most popular method of contraception for Brazilian women in general is female sterilization. In this context, the objective of this study was to assess demand for sterilization and sterilization rates among pregnant HIV-positive women in two Brazilian cities, Porto Alegre and Sao Paulo.

METHODS: All HIV-positive women (154 in Sao Paulo and 258 in Porto Alegre) who received prenatal care between July 1999 and June 2000 in six selected HIV specialized centers were included in the study: The clinic records were abstracted retrospectively. A sample of these women (30 in each city) were interviewed, once during pregnancy and again postpartum.

RESULTS: Postpartum sterilization rates were 4.3% (11/258) in Porto Alegre compared to 50.6% (78/154) in Sao Paulo. Significant predictors of sterilization include age, number of living children, type of childbirth and prenatal care services. At the same time, data from the qualitative study show that the desire to end childbearing is nearly universal: 29/30 in Porto Alegre and 28/30 in Sao Paulo.

CONCLUSIONS: A significant proportion of women in both cities desire to become sterilized after delivery. A much higher proportion of HIV-positive women in Sao Paulo became sterilized compared to infected women in Porto Alegre. While these results cannot be generalized to the entire population of HIV-positive pregnant women in Brazil, HIV-positive women in this sample had higher rates of sterilization than their uninfected counterparts. In addition, the local medical culture's views and practices regarding sterilization appear more important than the women's reproductive choice.

Keywords: AEGIS, Sterilization, Reproductive, HIV Infections, Culture, HIV Seropositivity, Choice Behavior, Acquired Immunodeficiency Syndrome, Contraception, Prenatal Care, Delivery, Obstetric, Contraception Behavior, Brazil, Pregnant Women, Human, Female, Child, Pregnancy, ethnology, surgery

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MoOrE1068