Document Detail

Patient-provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil.
MedLine Citation:
PMID:  20947284     Owner:  NLM     Status:  In-Process    
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.
Monica Malta; Catherine S Todd; Mark A Stibich; Thais Garcia; Diego Pacheco; Francisco I Bastos
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-13
Journal Detail:
Title:  Patient education and counseling     Volume:  81     ISSN:  1873-5134     ISO Abbreviation:  Patient Educ Couns     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8406280     Medline TA:  Patient Educ Couns     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  476-82     Citation Subset:  N    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Oswaldo Cruz Foundation, Social Science Department, National School of Public Health (DCS/ENSP), Rio de Janeiro, Brazil.
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