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 com munication about childbearing goals exists for HIV + men in clinical care.