title: HIV+ men need reproductive counseling too: Assessing childbearing goals and provider communication among HIV+ male patients in Rio de Janeiro, Brazil.
abstract: We assessed reported communication with HIV providers about reproductive plans among HIV+ men in Rio de Janeiro, Brazil, and factors associated with having had such communication. A total of N=311 HIV+ men (18-50 years) receiving HIV care at one of six public primary care clinics in Rio de Janeiro between 2008-2009 were surveyed. We used descriptive statistics, and multivariate logistic regression to identify factors associated with communication about childbearing with an HIV provider. HIV+ male patients (mean age=42.7 years, 57% mixed race; 23% bisexual, 51% married/committed partner, 61% with at least one biological child, 77% on ART) reported accepting attitudes of HIV and childbearing (51%), the desire (39%), and/or intention (19%) to have a future child, and reported communication with the HIV provider (14%) or their primary partner (28%) about having children. There were no significant differences between the responses of HIV+ heterosexual and bisexual men on the above outcomes. Men who discussed childbearing with their HIV provider were more likely to have accepting attitudes about HIV and childbearing [AOR 2.8, 95%CI (1.2-6.4), p=0.014], and intend to have a child [AOR 2.6, 95% CI (1.2-5.6), p=0.018], but less likely to have discussed this topic with their partner [AOR 0.32 (0.15-0.68), p=0.003]. Among men reporting communication, 40% (17/42) reported advice against having a child. An unmet need for collaborative, nonjudgmental, and provider-initiated communication about childbearing goals exists for HIV+ men in clinical care.
authors.affiliation: 1 University of Kansas Medical Center , Department of Family Medicine, Kansas City, Kansas.
authors.forename: Sarah
authors.initials: S
authors.lastname: Finocchario Kessler
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
authors.forename: Monica
authors.initials: M
authors.lastname: Malta
authors.forename: Neilane
authors.initials: N
authors.lastname: Bertoni
authors.forename: Homaira
authors.initials: H
authors.lastname: Hanif
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil; D003142:Communication; D003376:Counseling; D005298:Fertility; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D043762:Reproductive Behavior; D034121:Reproductive Health Services; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires