Patient–provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil

Malta, Mônica; Todd, Catherine S.; Stibich, Mark; Garcia, Thaís; Pacheco, Diego Felipe Peral; Bastos, Francisco I.

doi:10.1016/j.pec.2010.09.013

Cited by 26 publications

(29 citation statements)

References 26 publications

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“…4,5 While reported communication with HIV providers was not directly measured by Paiva and colleagues, they reported most participants did not feel health professionals were supportive enough or even impartial about their desire to have a child, and that men's knowledge of perinatal transmission risk was low. 4,5 Comparing our data to those of other studies directly assessing communication about future reproductive plans among HIV + men, we found 12 These findings were consistent with an observational study among HIV providers in Rio de Janeiro reporting limited communication about safer sexual practices. 23 While often neglected and far from being routine, sexual and reproductive health is more likely considered for HIV + female patients of reproductive age compared to their male counterparts.…”

Section: Discussionsupporting

confidence: 88%

“…[4][5][6] Recognizing the importance of having children among HIV + men, patients need to be able to discuss and plan such childbearing decision making with their HIV provider and partner. There is growing awareness of the unmet need for reproductive counseling among HIV + women in clinical care, as illustrated by recent studies in Brazil, 12,13 the United States, [14][15][16][17] and sub-Saharan Africa. 18,19 This same need for reproductive counseling among HIV + male patients has been largely ignored.…”

Section: Introductionmentioning

confidence: 99%

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HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

Bastos

Malta

et al. 2014

AIDS Patient Care and STDs

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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.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

Bastos

Malta

et al. 2014

AIDS Patient Care and STDs

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“…Hollen et al [48] concluded that the LCSS demonstrates (1) good feasibility, reliability and content validity and (2) high interrater reliability. Overall, the LCSS has consistently demonstrated good feasibility, reliability (internal consistency) and convergent validity [48,49,50,51]. For this study, Cronbach's α for the total scale was 0.94.…”

Section: Methodsmentioning

confidence: 76%

“…Stigma contributes to communication difficulties (i.e., stereotyping, status and power differentials between majority and minority groups and lack of cultural awareness of health professionals), which are implicated in poorer health service delivery and worse patient outcomes [49]. This barrier exists for many health conditions, including HIV, obesity and mental illness, and results in increased patient distress and poor patient outcomes [22,50,51,58]. Across all stages of disease, patients with lung cancer report inadequate patient communication related to the felt experience of stigma on key topics such as prognosis, palliative care and symptom management [58].…”

Section: Discussionmentioning

confidence: 99%

Lung Cancer Stigma, Anxiety, Depression and Symptom Severity

Cataldo

Brodsky²

2013

Oncology

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Objectives: Compared to other cancers, lung cancer patients report the highest levels of psychological distress and stigma. Few studies have examined the relationship between lung cancer stigma (LCS) and symptom burden. This study was designed to investigate the relationship between LCS, anxiety, depression and physical symptom severity. Methods: This study employed a cross-sectional, correlational design to recruit patients online from lung cancer websites. LCS, anxiety, depression and physical symptoms were measured by patient self-report using validated scales via the Internet. Hierarchical multiple regression was performed to investigate the individual contributions of LCS, anxiety and depression to symptom severity. Results: Patients had a mean age of 57 years; 93% were Caucasian, 79% were current or former smokers, and 74% were female. There were strong positive relationships between LCS and anxiety (r = 0.413, p < 0.001), depression (r = 0.559, p < 0.001) and total lung cancer symptom severity (r = 0.483, p < 0.001). Although its contribution was small, LCS provided a unique and significant explanation of the variance in symptom severity beyond that of age, anxiety and depression, by 1.3% (p < 0.05). Conclusions: Because LCS is associated with psychosocial and physical health outcomes, research is needed to develop interventions to assist patients to manage LCS and to enhance their ability to communicate effectively with clinicians.

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“…However, recent qualitative findings from 70 HIV-infected women in Rio de Janeiro (in press) found that with a few positive exceptions, most providers did not communicate at all with their patients about sexual behavior, fertility intentions, or contraception. When providers did make the effort, their form of communication was often closed-ended and perfunctory [35].…”

Section: Introductionmentioning

confidence: 99%

Discussing Childbearing with HIV-infected Women of Reproductive Age in Clinical Care: A Comparison of Brazil and the US

et al. 2011

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Despite long term access to highly active antiretroviral therapy in Brazil and the US, little is known about women's communication with their HIV provider regarding childbearing or the unmet need for reproductive counseling. We utilized identical survey questions to collect data from HIV-infected women of reproductive age in Rio de Janeiro (n = 180) and Baltimore (n = 181). We conducted univariate analyses to compare findings between samples of women and multivariate logistic regression to determine factors associated with childbearing desires, childbearing intentions, and provider communication among the combined sample of women (n = 361). Over one-third of women in Rio de Janeiro and nearly one-half of women in Baltimore reported the desire for future childbearing. Nevertheless, the majority of women in clinical care had not discussed future childbearing with their HIV provider. Even in countries with an advanced approach to HIV care, we found low and inadequate communication between providers and female patients about childbearing.

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Patient–provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil

Abstract: Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting.

Cited by 26 publications

References 26 publications

HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

Lung Cancer Stigma, Anxiety, Depression and Symptom Severity

Discussing Childbearing with HIV-infected Women of Reproductive Age in Clinical Care: A Comparison of Brazil and the US

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