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

GOGNA MÓNICA; PECHENY MARIO; MANZELLI HERNÁN; IBARLUCÍA INÉS; BARRÓN LÓPEZ SARA

SOCIAL SCIENCE AND MEDICINE

Elsevier

Año: 2009 p. 1 - 8

0277-9536

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 percent of women and 30 percent of men had had children after their HIV diagnosis and that half of those pregnancies had been unintended. At the time of the survey, 73 percent of men and 64 percent of women didn’t want a (new) pregnancy. A vast majority reports systematic condom use, but people acknowledge difficulties to comply with this recommendation. Dual protection (i.e., condom use plus another method) is practiced by one out of ten people who risk an unwanted pregnancy. 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 counselling were identified. Most physicians only indicate condoms while a minority refers patients to family planning providers or talk with them about contraception. Lack of updated information about interactions between antiretroviral drugs and hormonal contraception and/or IUD 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 tuned in order to fully respect people’s rights and succeed in preventing (re)infection as well as unwanted pregnancies. Building up on findings, recommendations to enhance the provision of adequate information and services to help people prevent unwanted pregnancies, or reproduce as safely as possible, are discussed.