Psychosocial aspects of HIV infection among women in Brazil

To analyze the risk perception among HIV-positive women before getting a positive test result. An exploratory study using in-depth interviews was conducted among 26 women who attended the outpatient clinic of a regional health center in Maringá, Brazil. The sample was drawn according to the women's availability. The interviews were carried out using a semi-structured questionnaire with open and closed questions on social-demographics, knowledge of primary and secondary prevention, risk perception before getting the test results, and impact of the diagnosis on their lives and sexual activity. Data was assessed using content analysis. Though the participants were aware that anyone could get infected, none of them believed they could actually be infected. Psychological mechanisms such as denial, avoidance, thought omnipotence, and projection are encouraged by practices and gender-dominant relationships in the Brazilian culture, which increases women's vulnerability to HIV infection. They feel helpless and many have unprotected sex with their partners, and are prone to unwanted pregnancies and re-infection. HIV prevention programs should take into account psychological, social, economical and cultural aspects that impact on women's vulnerability before and after being infected. For a wider outreach of actions, programs cannot to be restricted to massive information diffusion and need to apply psychoeducational strategies to small groups of women not only to increase their medical knowledge but also to enhance their awareness.