Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV

Detalhes bibliográficos
Autor(a) principal: Lima, Reângela Cíntia Rodrigues de Oliveira
Data de Publicação: 2023
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/71453
Resumo: Women living with HIV face many challenges related to their sexuality, reproduction, contraception and motherhood. The inconsistent use of contraceptives and unsafe sexual practices increase the chances of sexual and vertical HIV transmission, unplanned pregnancies, pregnancy complications and unsafe abortions. Thus, this study had the general objective of analyzing contraceptive practices and the reproductive desire of women living with HIV. Cross-sectional analytical research, carried out with 165 women with HIV through face-to-face interviews with a form to identify sociodemographic, clinical, sexual, reproductive data and decision-making power in the relationship; and a Questionnaire about values and beliefs about sexuality, motherhood and abortion with five domains (pleasure, affectivity, reproduction, motherhood, abortion). The outcome variables were: desire for pregnancy; contraceptive use and partner control. Data were analyzed using the Stata 13 software. Sociodemographic, clinical, sexual and reproductive characteristics were associated with the outcomes, using the χ2 test, p<0.05, prevalence ratio, 95% accuracy of the effect and bivariate analysis in the data with p<0.10. Of the total, 84 (50.9%) of the women were brown, with a mean age of 29.6 years and 120 (72.7%) had ≤ 9 years of education. Most of them 88 (53.3%) do not have children and 98 (60.1%) live with a serodiscordant partner. In sexual aspects, 103 (62.4%) of the women could not choose to use a condom during sexual intercourse and 67 (40.6%) the partner controls condom use. Regarding reproductive aspects, 57 (34.5%) of the women would have children just to please their partners and 109 (66.1%) talked about reproductive planning. As for the use of contraceptives, 102 (61.8%) of the women did not use contraceptives. Regarding health care, 115 (69.7%) assured that the health professional does not inform about pregnancy and vertical transmission and were emphatic in stating that they did not receive guidance on contraceptives 88 (53.4%). Most women with reproductive desire were married, had other children (p=0.042), used antiretrovirals, partners got what they wanted in the relationship (p=0.019) and had professional guidance (p 0.001). Among women who used contraceptives, there was an association with time studying (p 0.001); in choosing and using condoms (p=0.011), among those who discussed planning (p 0.001) and among those who reported that the partner has more control over important decisions that affect the relationship (63.6%), being associated with these findings the family income >1 minimum wage (p=0.001), the power to refuse to have sexual intercourse without a condom (p=0.049), the partner's control over the use or not of condoms (p=0.013), if the partner gets what he wants (p=0.040), if he felt forced to have sex (p 0.001), with monitoring by a health professional (p=0.028) and those who had already discussed planning with the partner (p=0.009) . It is concluded that among women with HIV, the minority uses contraceptive methods and has a desire for pregnancy after diagnosis of the infection and that the partners have more control in important decisions that affect the relationship, including issues related to sexual health and reproductive desire.
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spelling Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIVHIVAnticoncepçãoComportamento ReprodutivoAnticoncepcionaisWomen living with HIV face many challenges related to their sexuality, reproduction, contraception and motherhood. The inconsistent use of contraceptives and unsafe sexual practices increase the chances of sexual and vertical HIV transmission, unplanned pregnancies, pregnancy complications and unsafe abortions. Thus, this study had the general objective of analyzing contraceptive practices and the reproductive desire of women living with HIV. Cross-sectional analytical research, carried out with 165 women with HIV through face-to-face interviews with a form to identify sociodemographic, clinical, sexual, reproductive data and decision-making power in the relationship; and a Questionnaire about values and beliefs about sexuality, motherhood and abortion with five domains (pleasure, affectivity, reproduction, motherhood, abortion). The outcome variables were: desire for pregnancy; contraceptive use and partner control. Data were analyzed using the Stata 13 software. Sociodemographic, clinical, sexual and reproductive characteristics were associated with the outcomes, using the χ2 test, p<0.05, prevalence ratio, 95% accuracy of the effect and bivariate analysis in the data with p<0.10. Of the total, 84 (50.9%) of the women were brown, with a mean age of 29.6 years and 120 (72.7%) had ≤ 9 years of education. Most of them 88 (53.3%) do not have children and 98 (60.1%) live with a serodiscordant partner. In sexual aspects, 103 (62.4%) of the women could not choose to use a condom during sexual intercourse and 67 (40.6%) the partner controls condom use. Regarding reproductive aspects, 57 (34.5%) of the women would have children just to please their partners and 109 (66.1%) talked about reproductive planning. As for the use of contraceptives, 102 (61.8%) of the women did not use contraceptives. Regarding health care, 115 (69.7%) assured that the health professional does not inform about pregnancy and vertical transmission and were emphatic in stating that they did not receive guidance on contraceptives 88 (53.4%). Most women with reproductive desire were married, had other children (p=0.042), used antiretrovirals, partners got what they wanted in the relationship (p=0.019) and had professional guidance (p 0.001). Among women who used contraceptives, there was an association with time studying (p 0.001); in choosing and using condoms (p=0.011), among those who discussed planning (p 0.001) and among those who reported that the partner has more control over important decisions that affect the relationship (63.6%), being associated with these findings the family income >1 minimum wage (p=0.001), the power to refuse to have sexual intercourse without a condom (p=0.049), the partner's control over the use or not of condoms (p=0.013), if the partner gets what he wants (p=0.040), if he felt forced to have sex (p 0.001), with monitoring by a health professional (p=0.028) and those who had already discussed planning with the partner (p=0.009) . It is concluded that among women with HIV, the minority uses contraceptive methods and has a desire for pregnancy after diagnosis of the infection and that the partners have more control in important decisions that affect the relationship, including issues related to sexual health and reproductive desire.As mulheres vivendo com HIV enfrentam muitos desafios relacionados à sexualidade, reprodução, contracepção e maternidade. A utilização inconsistente de contraceptivos e práticas sexuais inseguras, aumentam as chances de transmissão do HIV, por via sexual e vertical, gestações não planejadas, complicações na gravidez e abortos inseguros. Assim, este estudo teve como objetivo geral analisar as práticas contraceptivas e o desejo reprodutivo de mulheres vivendo com HIV. Pesquisa analítica transversal, realizada com 165 mulheres com HIV, mediante a entrevista face a face, com formulário para identificação de dados sociodemográficos, clínicos, sexuais, reprodutivos e poder de decisão no relacionamento; e um questionário sobre valores e crenças sobre sexualidade, maternidade e aborto com cinco domínios (prazer, afetividade, reprodução, maternidade, aborto). As variáveis de desfecho foram: desejo de gravidez; uso de contraceptivo; e controle do parceiro. Os dados foram analisados pelo software Stata 13. As características sociodemográficas, clínicas, sexuais e reprodutivas foram associadas aos desfechos, utilizando-se do teste χ2, p<0,05, da razão de prevalência, da precisão do efeito 95% e análise bivariada dos dados com p<0,10. Do total, 84 (50,9%) das mulheres eram pardas, com idade média de 29,6 anos e 120 (72,7%) tinham ≤ 9 anos de estudo. A maioria delas, 88 (53,3%), não tinha filhos e 98 (60,1%) conviviam com parceiro sorodiscordante. Nos aspectos sexuais, 103 (62,4%) das mulheres não conseguiam escolher usar o preservativo nas relações sexuais e para 67 (40,6%), o parceiro controlava o uso do preservativo. Nos aspectos reprodutivos, 57 (34,5%) das mulheres teriam filhos apenas para agradar os companheiros e 109 (66,1%) conversavam sobre planejamento reprodutivo. Quanto ao uso de contraceptivos, 102 (61,8%) das mulheres não usavam contraceptivos. Em relação ao cuidado em saúde, 115 (69,7%) asseguraram que o profissional de saúde não informava sobre gravidez e transmissão vertical e foram enfáticas ao afirmar que não recebiam orientações sobre contraceptivos, 88 (53,4%). A maioria das mulheres com desejo reprodutivo, eram casadas, tinham outros filhos (p=0,042), usavam antirretrovirais, os parceiros conseguiam o que queriam no relacionamento (p=0,019) e tinham orientação profissional (p£0,001). Entre as mulheres que usavam contraceptivos, houve associação com tempo de estudo (p£0,001); na escolha e uso do preservativo (p=0,011), entre as que discutiam sobre planejamento (p£0,001) e nas que relataram que o parceiro tinha mais controle em decisões importantes que afetavam o relacionamento (63,6%), estando associado a esses achados a renda familiar >1 salário-mínimo (p=0,001), o poder de recusar a ter relação sexual sem o preservativo (p=0,049), o controle do parceiro sobre o uso ou não de preservativos (p=0,013), se o parceiro consegue o que quer (p=0,040), sentiu-se forçada a fazer sexo (p£0,001), com acompanhamento do profissional de saúde (p=0,028) e as que já discutiram planejamento com o parceiro (p=0,009). Concluiu-se que entre as mulheres com HIV, a minoria usava métodos contraceptivos e tinha desejo de gravidez após diagnóstico da infecção e que os parceiros tinham mais controle em decisões importantes que afetavam o relacionamento, incluindo as questões relacionadas à saúde sexual e ao desejo reprodutivo.Galvão, Marli Teresinha GimenizLima, Reângela Cíntia Rodrigues de Oliveira2023-03-27T10:27:41Z2023-03-27T10:27:41Z2023info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfLIMA, Reângela Cíntia Rodrigues de Oliveira. Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV. 2023. 134 f. Tese (Doutorado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2023. Disponível em: http://www.repositorio.ufc.br/handle/riufc/71453. Acesso em: 27 mar. 2023.http://www.repositorio.ufc.br/handle/riufc/71453porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2023-03-27T10:57:45Zoai:repositorio.ufc.br:riufc/71453Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:56:02.331207Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
title Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
spellingShingle Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
Lima, Reângela Cíntia Rodrigues de Oliveira
HIV
Anticoncepção
Comportamento Reprodutivo
Anticoncepcionais
title_short Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
title_full Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
title_fullStr Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
title_full_unstemmed Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
title_sort Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV
author Lima, Reângela Cíntia Rodrigues de Oliveira
author_facet Lima, Reângela Cíntia Rodrigues de Oliveira
author_role author
dc.contributor.none.fl_str_mv Galvão, Marli Teresinha Gimeniz
dc.contributor.author.fl_str_mv Lima, Reângela Cíntia Rodrigues de Oliveira
dc.subject.por.fl_str_mv HIV
Anticoncepção
Comportamento Reprodutivo
Anticoncepcionais
topic HIV
Anticoncepção
Comportamento Reprodutivo
Anticoncepcionais
description Women living with HIV face many challenges related to their sexuality, reproduction, contraception and motherhood. The inconsistent use of contraceptives and unsafe sexual practices increase the chances of sexual and vertical HIV transmission, unplanned pregnancies, pregnancy complications and unsafe abortions. Thus, this study had the general objective of analyzing contraceptive practices and the reproductive desire of women living with HIV. Cross-sectional analytical research, carried out with 165 women with HIV through face-to-face interviews with a form to identify sociodemographic, clinical, sexual, reproductive data and decision-making power in the relationship; and a Questionnaire about values and beliefs about sexuality, motherhood and abortion with five domains (pleasure, affectivity, reproduction, motherhood, abortion). The outcome variables were: desire for pregnancy; contraceptive use and partner control. Data were analyzed using the Stata 13 software. Sociodemographic, clinical, sexual and reproductive characteristics were associated with the outcomes, using the χ2 test, p<0.05, prevalence ratio, 95% accuracy of the effect and bivariate analysis in the data with p<0.10. Of the total, 84 (50.9%) of the women were brown, with a mean age of 29.6 years and 120 (72.7%) had ≤ 9 years of education. Most of them 88 (53.3%) do not have children and 98 (60.1%) live with a serodiscordant partner. In sexual aspects, 103 (62.4%) of the women could not choose to use a condom during sexual intercourse and 67 (40.6%) the partner controls condom use. Regarding reproductive aspects, 57 (34.5%) of the women would have children just to please their partners and 109 (66.1%) talked about reproductive planning. As for the use of contraceptives, 102 (61.8%) of the women did not use contraceptives. Regarding health care, 115 (69.7%) assured that the health professional does not inform about pregnancy and vertical transmission and were emphatic in stating that they did not receive guidance on contraceptives 88 (53.4%). Most women with reproductive desire were married, had other children (p=0.042), used antiretrovirals, partners got what they wanted in the relationship (p=0.019) and had professional guidance (p 0.001). Among women who used contraceptives, there was an association with time studying (p 0.001); in choosing and using condoms (p=0.011), among those who discussed planning (p 0.001) and among those who reported that the partner has more control over important decisions that affect the relationship (63.6%), being associated with these findings the family income >1 minimum wage (p=0.001), the power to refuse to have sexual intercourse without a condom (p=0.049), the partner's control over the use or not of condoms (p=0.013), if the partner gets what he wants (p=0.040), if he felt forced to have sex (p 0.001), with monitoring by a health professional (p=0.028) and those who had already discussed planning with the partner (p=0.009) . It is concluded that among women with HIV, the minority uses contraceptive methods and has a desire for pregnancy after diagnosis of the infection and that the partners have more control in important decisions that affect the relationship, including issues related to sexual health and reproductive desire.
publishDate 2023
dc.date.none.fl_str_mv 2023-03-27T10:27:41Z
2023-03-27T10:27:41Z
2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv LIMA, Reângela Cíntia Rodrigues de Oliveira. Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV. 2023. 134 f. Tese (Doutorado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2023. Disponível em: http://www.repositorio.ufc.br/handle/riufc/71453. Acesso em: 27 mar. 2023.
http://www.repositorio.ufc.br/handle/riufc/71453
identifier_str_mv LIMA, Reângela Cíntia Rodrigues de Oliveira. Comportamento contraceptivo e decisão reprodutiva de mulheres no contexto do HIV. 2023. 134 f. Tese (Doutorado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2023. Disponível em: http://www.repositorio.ufc.br/handle/riufc/71453. Acesso em: 27 mar. 2023.
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