The reproductive needs and rights of people living with HIV in Argentina: health service users? and providers? perspectives

GOGNA, MONICA; PECHENY, MARIO; IBARLUCÍA, INÉS; MANZELLI, HERNÁN; BARRÓN LÓPEZ, SARA

SOCIAL SCIENCE AND MEDICINE

PERGAMON

Año: 2009 vol. 69 p. 813 - 820

0277-9536

Gogna, M.; Pecheny, M.; Ibarlucía, I.; Manzelli, H. y Barrón López, S., 2009. ?The reproductive needs and rights of people living with HIV in Argentina: health service users? and providers? perspectives?, Social Sciences & Medicine 69(6): 813-820. ISSN 0277-9536. ·        Indexada: Los artículos publicados en Social Sciences & Medicine están indexados por: Scopus; MEDLINE®; Elsevier BIOBASE; Social Sciences Citation Index; EMBASE; Sociological Abstracts; Tropical Diseases Bulletin; ASSIA; Abstracts in Hygiene and Communicable Diseases; BIOSIS; CINAHL; Current Contents/Health Services Administration; Current Contents/Social & Behavioral Sciences; Geographical Abstracts; Hyg Abstr; PASCAL/CNRS; Psychology Abstracts; Research Alert. This article focuses on the contraceptive and reproductive experiences and needs of people living with HIV and on public health services? responses to them in Argentina. Data collected through a national survey amongst people living with HIV (N 841) and semi-structured interviews (N 89) explored the perspectives of both health-care users and HIV/AIDS program coordinators and providers. The survey revealed that 55% of women and 30% of men had had children after their HIV diagnosis and that half of those pregnancies had been unintended. At the time of the survey in 2006, 73% of men and 64% of women did not want a (new) pregnancy. The vast majority report systematic condom use, but acknowledge difficulties complying with this recommendation. Dual protection (i.e., condom use plus another method) is low among those who do not want children or another pregnancy (8% of women and 9% of men reported using it). Mostly women and heterosexual men without children either expressed their wish or were seeking to be parents. Institutional and cultural barriers to friendly and/or effective contraceptive and reproductive counseling were identified. Most physicians encourage only condom use while a minority refers patients to family planning providers or talk with them about contraception. A lack of updated information about interactions between antiretroviral drugs and hormonal contraception and/or intra-uterine devices was not infrequent among providers. Users reported having being discouraged or blamed by health professionals when they revealed they wanted to have (or were expecting) a baby. Professionals and program directors? attitudes regarding reproduction range from not acknowledging people?s wishes, to providing useful information or referral. Whether wanted or unexpected, parenthood is a challenge for many of the people living with HIV. Social and biomedical responses still need to be refined in order to fully respect people´s rights and succeed in preventing (re)infection as well as unwanted pregnancies. Drawing on study results, recommendations to enhance the provision of adequate information and services to help people prevent unwanted pregnancies or reproduce as safely as possible are discussed.