HIV infections are becoming more common among heterosexually active women in sentinel communities. Despite the fact that fertility related behaviors can effect an individual's risk of acquiring and transmitting the virus as well as effect the rate of its sexual and perinatal spread in a community, little is known about how attitudes towards HIV, knowledge about it, relative risk for its acquisition and being diagnosed as infected with HIV is being reflected in fertility related behaviors. These behaviors include choice of contraception and consistency of use, choosing whether to maintain a pregnancy and choosing whether to partake in CDC recommended pre-conceptional and prenatal HIV testing programs. In this study a sentinel community, with a documented high prevalence of HIV in women will be assessed. Women presenting for prenatal, gynecologic and family planning will have questionnaires administered which will focus on attitudes, knowledge and risks related to HIV and other STDs as well as other factors known to effect fertility choices. Physical examination and microbiologic studies will be performed to diagnosis the presence of other STDs and women will be offered HIV testing. The tests for other STDs will serve as surrogate markers of risk behaviors. Additionally on return visits patients diagnosed as having STDs will be reassessed to see how that diagnosis influences their reproductive choices.
The aims of this research are to determine how attitudes toward, knowledge of and risk for HIV are effecting fertility related behavior including the decision to be tested for HIV. The board long term objective is to guide strategies to engage women in """"""""safer sex"""""""" in sentinel communities.
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