Drug regimens and procedures now exist that will prevent parents from transmitting HIV to infants, and the ethical and legal obligation to promote and protect the reproductive rights of those living with HIV should form part of training for HIV/AIDS care and prevention. This paper reports a study that investigated issues of sexuality and reproduction with 250 Brazilian men living with HIV in São Paulo. We asked whether they wished to have children and whether health professionals in HIV/AIDS treatment clinics that they attended were supportive of their wishes. Health professionals were not considered by most participants to be supportive enough or even impartial about HIV-positive people having children, and paid little attention to men's fathering role. 80% of the men had sexual relationships, and 43% of them wanted children, especially those who had no children, in spite of expectations of disapproval. Few of the men received information about treatment options that would protect infants, however. In previous studies with HIV-positive women attending the same clinics, by comparison, greater knowledge about prevention of perinatal HIV transmission was reported, but women had fewer sexual relationships, fewer desired to have children, and they expected even more disapproval of having children from health professionals. We conclude that the rights of those with HIV to found a family depend as much on curing the ills of prejudice and discrimination, including among health professionals, as on medical interventions.

Links between HIV/AIDS care and reproductive health, including fertility options for people living with HIV (PLWH), have not been sufficiently addressed by health care providers. Moreover, few studies have addressed men in this regard. To describe attitudes toward parenthood and identify factors associated with desire to have children among men and women living with HIV a cross-sectional study involving a sample of 533 women and 206 men (bisexual and heterosexual) attending two reference sexually transmitted disease (STD)/AIDS centers in São Paulo, Brazil. Participants answered a standardized questionnaire. Desire to have children as the study outcome was compared between men and women and associated factors searched for in multivariable regression analysis. In contrast to previous studies conducted in developed countries, desire to have children in this sample was more frequent among men than among women and it was reported by 27.9% of participants (50.1% of men versus 19.2% of women). Women were more likely to anticipate doctors' strong opposition to PLWH getting pregnant and men reported lower information level about HIV/mother-to-child transmission (MTCT). Bisexual men were more likely to desire to have biologic children. Male gender, younger age, having no children, living with 1-2 children, and being in a heterosexual partnership were independently associated with desire to have children. Regardless of gender, the childless as well as the youngest should be regarded as groups to be particularly targeted by counseling, to be provided with objective information about reproductive rights and options. Further research is warranted to address the desire for children among strictly homosexual men.

Desafios permanecem na prevenção e cuidado da aids. Nesse artigo apresentamos resultados de pesquisa com 250 homens portadores do HIV que fazem sexo com mulheres, sobre o cuidado à sua saúde reprodutiva em centros de referência de aids e comparamos com estudos entre mulheres portadoras. 43% dos homens e até 20 % das mulheres entrevistadas querem ter filhos, principalmente os que não têm filhos. 85% dos homens mantém atividade sexual e é baixo o nível de informação sobre reprodução na condição de portadores. Apesar das conquistas que permitem a paternidade sem infecção da parceira e da criança, os resultados indicam pouco acolhimento, mesmo nos centros de excelência pesquisados. Sugerimos como temas centrais no treinamento de profissionais e na organização de programas: a obrigatoriedade ética e constitucional de promoção dos direitos reprodutivos, desafiar o estigma anti-família associado às pessoas vivendo com HIV e às noções essencialistas que naturalizam as definições sobre a família e os gêneros.

Aborto induzido entre mulheres em idade reprodutiva vivendo e não vivendo com HIV/aids no BrasilInduced abortion in women of reproductive age living with and without HIV/Aids in BrazilResumo No presente estudo, buscou-

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