HIV-positive women in northeast Brazil: Tubal sterilization, medical recommendation and reproductive rights

Abstract

Tubal sterilization is the most common contraceptive method used by Brazilian HIV-positive women. This cross sectional study describes the main reasons why HIV-positive women decide to be sterilized and identifies factors associated with choosing sterilization in HIV-positive women in Ceará, northeast Brazil. Data from 229 non-sterilized women, 80 women sterilized before HIV diagnosis and 48 women sterilized after diagnosis were analysed. Of the women sterilized after HIV diagnosis, 96% had the procedure done in the postpartum, during a caesarean section. No desire for more children was the most common appointed reason to be sterilized (39.6%), followed by medical recommendation because of HIV (31.3%). Seventy-nine women (28.5%) had a child after HIV diagnosis. Of those, 46 (58.2%) were sterilized in the postpartum. Factors associated with sterilization for HIV-positive women were: having a child after diagnosis (AOR: 120.9; 95%CI: 27.8–525.4) and having at least three children (AOR: 2.8; 95%CI: 1.1–7.1). It is recommended that non-coercive counselling should be provided so that HIV-positive women can make informed decisions on their reproductive options.

Acknowledgements

This study was funded by the National STD/AIDS Program of the Brazilian Ministry of Health (number 279/03) and the Ford Foundation. FAO received a scholarship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and AN from the Fundação Cearense de Apoio à Pesquisa.