title: Mirror, mirror on the wall: the face of HIV + women in Europe today.
abstract: Sexual and reproductive health (SRH) and rights are important components of quality of life. This cross-sectional study describes HIV-positive women's SRH aspirations and needs and the predictive value of selected SRH factors on condom use with steady sexual partners. Data were collected in a European multi-centre study in 17 HIV centres in 14 European countries by a standardised anonymous self-administered questionnaire. Descriptive statistics and hierarchical regression analysis were carried out and qualitative data from related formative research illustrated the findings. Among 387 HIV-positive women, 57% had children and 35% had become pregnant since their HIV-diagnosis. Contraceptive needs were largely unmet: 14% had undergone a pregnancy termination. About 83% changed their sexual behaviour after HIV-diagnosis in some ways. Sixty-two percent had at least one sexual encounter with a steady partner during the past six months and 51% used condoms consistently. Significant correlations with condom use were identified for childbearing since HIV-diagnosis (r=-0.21, p<0.01), miscarriage since HIV-diagnosis (r=-0.24, p<0.01), the use of contraception (r=0.47, p<0.001) and changes in sexual behaviour after HIV-diagnosis (r=0.20, p<0.01). Hierarchical regression analysis controlled for education, migration background, age, undetectable viral load and partners' serostatus. The following significant predictors for condom use were established: the use of contraceptives (beta=0.33, p<0.001); miscarriage since HIV-diagnosis (beta=-0.16, p<0.01); childbearing since HIV-diagnosis (beta=-0.12, p<0.05); and having an HIV-positive partner (beta=-0.13, p<0.05). For study population, consistent condom use performed a challenge. Selected SRH-issues predicted condom use. Sexual risk reduction and positive prevention should be discussed in the context of family planning and integrate SRH perspectives in routine HIV care.
authors.affiliation: Department of Clinical Sciences, Prins Leopold Institute of Tropical Medicine, Antwerp, Belgium. cnoestlinger@itg.be
authors.forename: C
authors.initials: C
authors.lastname: Nostlinger
authors.forename: S
authors.initials: S
authors.lastname: Niderost
authors.forename: R
authors.initials: R
authors.lastname: Woo
authors.forename: T
authors.initials: T
authors.lastname: Platteau
authors.forename: J
authors.initials: J
authors.lastname: Loos
authors.forename: R
authors.initials: R
authors.lastname: Colebunders
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006679:HIV Seropositivity / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult