[Impact of counseling on the sexual habits and reproductive decisions in HIV-1-positive subjects]. FT Ruolo del counselling sulle abitudini sessuali e scelta riproduttiva in soggetti HIV-1 positivi.

BACKGROUND: To assess the results of counselling on sexual behavior and reproductive choices of couples discordant for HIV-1, in South-Eastern Italy. Setting: University Hospital, Apulia region, South-Eastern Italy. METHODS: In the period March 1985-December 1995, one hundred and forty-four HIV-1 discordant couples were enrolled. They were followed up for a median period of 39 months (range 12-60 months). Behavioural counselling was performed at each visit of the infected case and the sexual partner was periodically tested for HIV-1 antibodies. RESULTS: Sixty percent of couples pursued in unprotected sex intercourse, 30 new infections being diagnosed during the study period (cumulative incidence rate = 21%). In addition, 49 pregnancies in 38 women were recorded. Termination was very seldom the choice of pregnant women. CONCLUSIONS: There is a clear indication for a failure in the counselling process. A change in population characteristics is to be pointed out as the main factor of the results. More appropriate counselling modalities need to be introduced for the different targets of sexual behaviour of our population.