S291Acesso a cuidados relativos à saúde sexual entre mulheres que fazem sexo com mulheres em São Paulo, Brasil Access to sexual health care for women who have sex with women in São Paulo, Brazil

Este artigo tem como objetivo identificar os contextos de vulnerabilidade para o HIV entre mulheres brasileiras. Entre novembro de 2003 a dezembro de 2004 foi realizado um estudo de corte transversal em 13 municípios distribuídos nas cinco regiões do país, incluindo, respectivamente, 1.777 mulheres com diagnóstico positivo para HIV e 2.045 mulheres usuárias de serviços públicos de atenção à saúde da mulher sem diagnóstico conhecido de soropositividade para o HIV. A comparação entre os dois grupos mostrou que as mulheres com diagnóstico de HIV/AIDS não apresentaram um número de parceiros significativamente diferente com relação às mulheres sem diagnóstico de HIV/AIDS. No entanto, as mulheres vivendo com HIV/AIDS apresentaram início da vida sexual mais precoce, menor aderência ao uso de preservativos, e uma maior proporção dessas mulheres relatou uso de drogas, ocorrência de DST e de violência sexual na vida. Tais resultados sugerem a importância de pensar em estratégias de prevenção voltadas para o fortalecimento das mulheres e não apenas focadas em seus comportamentos individuais.

In Brazil, an increasing proportion of new HIV infections and AIDS cases involve women of reproductive age. To describe the reproductive desire of women with HIV/AIDS and to identify factors associated with the desire for motherhood, a cross-sectional study was carried out in the referral hospital for infectious diseases in Ceará State, northeast Brazil. In total, 229 women were included in data analysis. Median age was 32 years (interquartile range, 26-37), and 63% had a monthly family income of less than 210 USD. Forty-nine percent were using a contraceptive method, and 37% wished to undergo tubal ligation. Sixty-four percent of the latter women were motivated by the fear of having an HIV-positive child. Forty percent of the participants wanted to have a child. In the multivariate regression analysis, variables independently associated with women's desire to have a child were: younger age (in years, odds ration [OR] = 0.94; 95% confidence interval [CI]: 0.90-0.98), number of children (OR = 0.73; 95% CI: 0.57-0.96), and partner's desire for a child (OR = 3.35; 95%CI: 1.75-6.39). Having a partner who did not know about the woman's positive serostatus was negatively associated with the woman's desire for a child (OR = 0.17; 95% CI: 0.04-0.69). No variable related to clinical status was significantly associated with the outcome variable. Our data showed that many unsterilized HIV-positive women in northeast Brazil, at whatever stage of illness, have a desire for children. We recommend that nondirective counseling, consisting of helping women evaluate their own feelings, goals and needs with respect to reproductive options be provided.

OBJECTIVE:To analyze the levels, tendencies and sociodemographic differentials of condom use among the Brazilian urban population. METHODS:The data analyzed was collected in 1998 and 2005, in the study, "Sexual Behavior and Perceptions of the Brazilian Population concerning HIV/ Aids". The probabilistic samples, in multiple stages, included men and women aged 16 to 65 years old, living in urban areas. Interviews with individuals that had been sexually active during the 12 months preceding the interview were included in the analysis. The univariate models were based on chi-square tests, corrected by sample planning, and odds ratio calculations; multivariate analysis involved adjustment of logistic regression models, controlling all other interest variables. RESULTS:There was a signifi cant increase in the use of condoms in the 12 months preceding the interview and at the last sexual intercourse. Young people from 16 to 24 years of age protected themselves more in sexual intercourse, particularly with eventual partners. Men used condoms more frequently only when they had an eventual partner. The use of condoms was more frequent among single people. There were no regional differences with respect to the consistent use of the condom. In stable relationships Pentecostals reveal the least amount of protection in sexual intercourse. People who have no religious affi liation or adepts of other religions have higher rates of protection. Level of education, an important differential with respect to the use of condoms in 1998, maintained its prominence in 2005. CONCLUSIONS:The results indicate the need for greater in depth discussion concerning actions that are geared towards increasing the consistent use of condoms, particularly among populations with lower educational levels and those that are more vulnerable, such as young women or women in stable relationships.