[Reproduction and sexuality in HIV-positive women, Brazil].

OBJECTIVE To assess sexual and reproductive health needs of HIV-positive women and factors that affect their access to prevention, safer sex practices and treatment and to appraise their ability of making informed choices concerning motherhood. METHODS This exploratory study was conducted among women of an outpatient clinic in a reference center for STD/AIDS in the city of São Paulo, Brazil, in 1997. A consecutive non-probabilistic sample of 148 HIV-positive women was investigated. The exclusion criteria included those aged under 18 years and who were physically unable. Data were collected using structured interviews. Statistical analysis was performed using Chi-square test and t-test. RESULTS The participants' mean age was 32 years old. As for education, 92 women (62.2%) had completed elementary school and 12.2% had attended university. The median number of lifetime sexual partners was 4, and half of the interviewees were still sexually active after diagnosed HIV-positive. Of the total, 76% had children and 21% were still thinking about having children in future. Having many children, alive and living with their mothers were determinant factors for not wanting any more children. It was found no association between wanting children, risk perception, partner's serologic status, contraceptive use and other factors. After getting HIV infected, there was a substantial change in the contraceptive methods used. CONCLUSIONS HIV infection did not change women's desire for having children. HIV-positive women's sexual and reproductive rights need to be discussed and respected in health care settings. Compliance to medication and safe sex practices are essential but difficult to meet requiring both counseling and support. Couples' counseling on reproductive choices is important for preventing infection of negative partners. Supportive services that promote open discussions of the sexual and reproductive rights of HIV-positive women are urgently needed.