{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T20:06:03Z","timestamp":1771877163662,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T00:00:00Z","timestamp":1554681600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Systematic reviews show that women living with HIV<\/jats:styled-content> (WLHIV<\/jats:styled-content>) have high unmet sexual and reproductive health (SRH<\/jats:styled-content>) needs due to barriers to access sexual and reproductive health services (SRHS<\/jats:styled-content>). In Latin America and the Caribbean (LAC<\/jats:styled-content>), as of 2016, there were nearly one million WLHIV<\/jats:styled-content>, but the existing evidence of their SRH<\/jats:styled-content> needs comes from a few individual studies. This systematic review provides an overview of these women's needs to help define new and\/or adapt existing public health strategies to the local context. This review synthesizes the evidence from the literature on the use of and access to SRHS<\/jats:styled-content> related to family planning, antenatal care, abortion services and violence against WLHIV<\/jats:styled-content> in LAC<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Using a systematic review of mixed studies, a search was performed in MEDLINE<\/jats:styled-content>, EMBASE<\/jats:styled-content>, LILACS<\/jats:styled-content>, INASP<\/jats:styled-content>, POPLINE<\/jats:styled-content>, SCOPUS<\/jats:styled-content>, for studies conducted in LAC<\/jats:styled-content>, from 2004 to 2017, as well as contact with authors and hand search as needed. Two independent reviewers evaluated the quality of the studies using the Mixed Methods Appraisal Tool; inclusion was conducted according to the PRISMA<\/jats:styled-content> flow diagram. An exploratory narrative synthesis followed by quantitative synthesis data was undertaken. Group analysis or meta\u2010analysis was not considered appropriate given the level of heterogeneity of the studies.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 18 studies in 13 LAC<\/jats:styled-content> countries for a population of 5672 WLHIV<\/jats:styled-content> were included. Data from individual studies reported unmet family planning needs; higher, but inconsistent use of condom as the sole contraceptive method OR<\/jats:styled-content>=1.46 [1.26 to 1.69]; lesser use of other non\u2010permanent contraceptive methods OR<\/jats:styled-content>=0.26 [0.22 to 0.31]; more unplanned pregnancies OR<\/jats:styled-content>=1.30 [1.02 to 1.66]; more induced abortions OR<\/jats:styled-content>=1.96 [1.60 to 2.39]; higher risk of immediate postpartum sterilization; and higher exposure to sexual and institutional violence by WLHIV<\/jats:styled-content> when compared with women without HIV<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>This review presents evidence from LAC<\/jats:styled-content> about the SRH<\/jats:styled-content> unmet needs of WLHIV<\/jats:styled-content> that must be addressed by decreasing institutional and structural barriers, facilitating services and reducing stigma, and discrimination among healthcare providers to improve access to SRHS<\/jats:styled-content> based on human rights, so women independently of their HIV<\/jats:styled-content> status can make their own reproductive decisions, free of violence and coercion.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25273","type":"journal-article","created":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T15:12:01Z","timestamp":1554736321000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Access to sexual and reproductive health services for women living with HIV<\/scp> in Latin America and the Caribbean: systematic review of the literature"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1942-4201","authenticated-orcid":false,"given":"Marcela","family":"G\u00f3mez\u2010Su\u00e1rez","sequence":"first","affiliation":[{"name":"The National University of Colombia Interfaculty Doctoral Program in Public Health Bogot\u00e1 Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maeve B","family":"Mello","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases and Environmental Determinants of Health HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Infections Unit Pan American Health Organization Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica Alonso","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases and Environmental Determinants of Health HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Infections Unit Pan American Health Organization Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Ghidinelli","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases and Environmental Determinants of Health HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Infections Unit Pan American Health Organization Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases and Environmental Determinants of Health HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Infections Unit Pan American Health Organization Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"United Nations.Women's rights are human rights.Geneva: Office of the High Commissioner in Human Rights;2014. 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