Vulnerability, human rights, and comprehensive health care needs of young people living with HIV/AIDS.

We sought to identify and understand the health care needs of young people living with HIV/AIDS, particularly in terms of their psychosocial well-being. We conducted a qualitative analysis of HIV-positive young people and their caregivers, focusing on the implications of an HIV diagnosis for health care needs. Stigma was a recurrent issue that arose in the interviews conducted with the respondents, and it was evident that youths had been denied many rights related to health. We concluded that young people living with HIV need comprehensive care based on a human rights approach. In this regard, we offer some practical recommendations for health programs.

[Sexuality of women living with HIV/AIDS in São Paulo]. / Sexualidade de mulheres vivendo com HIV/AIDS em São Paulo.

The social and cultural setting which increases female vulnerability to HIV does not disappear when women living with HIV/AIDS discover that they are infected. Following diagnosis, new challenges arise in their emotional lives, an issue which has received little attention in the literature. This study interviewed 1068 women living with HIV/AIDS using a questionnaire consisting of both open and closed questions, aimed at describing aspects of their sexual and reproductive lives and how they perceive counseling at Reference Centers in two cities in the State of São Paulo, where they have access to free antiretroviral therapy. Of the women with stable sexual partners, 63% used condoms in all their sexual relations, or three times the national average; 43% of the partners were HIV-negative and 14% had unknown serological status; 73% of the women had children and 15% were considering becoming pregnant. Knowledge on mother-to-child transmission was less than expected, and the interviewees complained of limited space and receptiveness for discussing sexuality, especially with regard to their childbearing wishes. Counseling on sexuality should be a continuing process and requires interdisciplinary training for the professional team working in health care services, with an emphasis on sexual and reproductive rights.

Sexualidade de mulheres vivendo com HIV/AIDS em Säo Paulo / Sexuality of women living with HIV/AIDS in Säo Paulo

O contexto sócio-cultural que aumenta a vulnerabilidade feminina ao HIV näo desaparece quando as mulheres vivendo com HIV/AIDS (MVA) se descobrem infectadas. Diagnosticadas, novos desafios väo aparecer na sua vida afetiva, poucos descritos na literatura. Foram entrevistadas 1.068 MVA com a utilizaçäo de um questionário composto de questöes abertas e fechadas, visando descrever aspectos da sua vida sexual e reprodutiva e como elas percebem o aconselhamento nessa área, quando säo atendidas em Centros de Referência, em duas cidades de Säo Paulo onde têm acesso gratuito aos medicamentos anti-retrovirais. Das mulheres que têm parceiro sexual estável, 63 por cento usam camisinha em todas as relaçöes sexuais, o triplo da média nacional; 43 por cento dos parceiros säo HIV negativos, 14 por cento têm sorologia desconhecida; 73 por cento têm filhos e 15 por cento pensam em tê-los. O conhecimento sobre transmissäo materno-infantil é menor do que o esperado, e as entrevistadas referem pouco espaço e acolhimento para discutir sexualidade, em especial suas intençöes reprodutivas. O aconselhamento sobre sexualidade deve ser um processo contínuo no atendimento e requer o treinamento interdisciplinar dos profissionais atuando em serviços de saúde, com ênfase nos direitos sexuais e reprodutivos