Risk perception and counselling among HIV-positive women in São Paulo, Brazil.

This study of HIV-positive women at a clinic for HIV/AIDS in São Paulo examined their risk perception for HIV before they had learned of their diagnosis and their experiences with pre- and post-test counselling. A sample of 148 women was interviewed regarding demographics, HIV risk factors and risk perception, pre- and post-test counselling, and sexual and reproductive conduct. The majority (77%) had been infected by their partners--37% by an injecting drug user partner. More than half (53%) did not perceive themselves at risk before learning of their HIV status and, of 68 who had perceived themselves at risk, 29% did so only after their partners became ill. The majority (64%) did not receive any kind of pre-test counselling. Post-test counselling was reported by 83% but 14% reported being mishandled by a physician in the process. Findings suggest the importance of prevention efforts to reduce women's barriers to learning about HIV status and the necessity of improving the quality of pre- and post-test counselling.

Influence of HIV positive status on sexual behavior among males.

OBJECTIVE: To compare HIV seronegative (HIV-) and HIV seropositive (HIV+) males in terms of sexual behavior with female and male partners of different types. METHOD: Cross-sectional study. From August 1994 to February 1995, a sample of 236 respondents (150 HIV- and 86 HIV+) recruited from public health centers in the State of S. Paulo (Brazil), answered a questionnaire, including questions on demographic aspects, HIV and AIDS related knowledge, sexual orientation, use of alcohol and other drugs, sexual behavior with regular and casual female and male partners, and perceived risk of HIV infection. Sexual behavior with regular and casual female and male partners within the previous three months, was investigated. RESULTS: A lower proportion of HIV+ engaged in sexual contact with regular female partners (p < .01) and in vaginal intercourse with this type of partner (p < .01). A lower proportion of HIV+ engaged in overall sexual activity (p < .001) and reported lower frequency of penetrative sexual practices (p < .05). A high level of condom use with female and male partners was identified with no significant differences being found between the two serostatus groups. Some risky sexual behavior was identified, however, especially with regular partners, suggesting that some men were continuing to practice unsafe sex. CONCLUSIONS: The high level of condom use identified suggests that safer sex advice has been taken up. Condom use was not universal, however, and some men continue to place themselves at risk, especially with regular partners. Prevention programs should strive not only to encourage HIV- to practice safer sex, but also to encourage HIV+ to do so in order to prevent further transmission of the virus.

PIP: Findings are presented from a cross-sectional study comparing the sexual behavior of HIV-seronegative and HIV-seropositive men with male and female sex partners, with particular focus upon the practice of safer sex in both groups of men. The 150 HIV-seronegative and 86 HIV-seropositive participating males were recruited between August 1994 and February 1995 from public health centers in the state of Sao Paulo, Brazil, where they responded to a questionnaire. The men were 15-69 years old, of mean age 30 years. 78% were single, 14.4% were married/living together, 6.4% were separated/divorced, and 1.3% were widowers. 36% defined themselves as heterosexuals, 11.4% as bisexuals, and 36.4% as homosexuals, while 16.1% used other expressions. Compared to HIV-seronegative men, a smaller proportion of HIV-seropositive men had sexual contact with regular female partners and engaged in vaginal intercourse with that type of partner. Similarly, a smaller proportion of HIV-seropositive men engaged in overall sexual activity and reported a lower frequency of penetrative sexual practices. A high level of condom use with male and female sex partners was identified with no significant differences being found between the 2 serostatus groups. However, some risky sexual behavior was identified, especially with regular partners, suggesting that some men were continuing to have unsafe sex. HIV prevention programs should encourage both HIV-seronegative and HIV-seropositive men to practice safer sex.