A Qualitative Assessment of Decisions Affecting Contraceptive Utilization and Fertility Intentions among HIV-Positive Women in Soweto, South Africa

Laher, Fatima; Todd, Catherine S.; Stibich, Mark; Phofa, Rebecca; Behane, Xoliswa; Mohapi, Lerato; Gray, Glenda

doi:10.1007/s10461-009-9544-z

Cited by 60 publications

(71 citation statements)

References 30 publications

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“…The key role of men in peri-conception decisions has been highlighted in previous studies reporting that pregnancies unintended by women were often desired by male partners. 16,25,29,[33][34][35][36] In our study, fertility decision-making was characterized by most women as having joint participation and not primarily an expression of male dominance. However, some scenarios were indicative of imbalanced gender power because women were motivated to conceive in order to please male partners.…”

Section: Discussionmentioning

confidence: 66%

Fertility Decision-Making Among Kenyan HIV-Serodiscordant Couples Who Recently Conceived: Implications for Safer Conception Planning

Pintye

Ngure

Curran

et al. 2015

AIDS Patient Care and STDs

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HIV-serodiscordant couples often choose to attempt pregnancy despite their HIV transmission risk. Optimizing delivery of HIV risk reduction strategies during peri-conception periods (i.e., safer conception) requires understanding how HIV-serodiscordant couples approach fertility decisions. We conducted 36 in-depth individual interviews with male and female partners of Kenyan heterosexual HIV-serodiscordant couples who recently conceived. Transcripts were analyzed by gender and HIV serostatus using open coding. Matrices were used to identify patterns and emerging themes. Most participants expressed acceptance of being in an HIVserodiscordant couple and affirmed their resilience to live with serodiscordance and achieve their fertility goals. Overall, while the goal for childbearing was unchanged, conception became an urgent desire so that both partners could experience childrearing together while the HIV-infected partner was still healthy. Children also add value to the relationship, and multiple children were a commonly expressed desire. Couples' desires dominated those of individual partners in fertility decision-making, but male preferences were more influential when the individual desires differed. Values and preferences of the couple as a unit may mediate fertility decision-making in HIV-discordant couples. Thus, it is important that safer conception programs include both partners when appropriate and consider the relationship context during risk reduction counseling and when recommending risk reduction interventions.

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Section: Discussionmentioning

confidence: 66%

Fertility Decision-Making Among Kenyan HIV-Serodiscordant Couples Who Recently Conceived: Implications for Safer Conception Planning

Pintye

Ngure

Curran

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…However, in some countries where the HIV prevalence rate is high, contraceptive use is reasonably low. High rates of unmet contraceptive need and unplanned pregnancy have been reported among HIV infected women in Malawi, South Africa, and Uganda [25][26][27][28] . In Uganda, the contraceptive prevalence rate among currently married women is 24% which is very low compared to the countries Ireland (89%), Norway (88%), etc.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the HIV/AIDS epidemic: An ecological analysis of global data

Mondal¹,

Shitan²

2013

Afr H. Sci.

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Background: All over the world the prevalence of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) has became a stumbling stone in progress of human civilization and is a huge concern for people worldwide. Objective: To determine the social and health factors which contribute to increase the size of HIV epidemic globally. Methods: The country level indicators of HIV prevalence rates, are contraceptive prevalence rate, physicians density, proportion of Muslim populations, adolescent fertility rate, and mean year of schooling were compiled of 187 countries from the United Nations (UN) agencies. To extract the major factors from those indicators of the later five categories, backward multiple regression analysis was used as the statistical tool. Results: The national HIV prevalence rate was significantly correlated with almost all the predictors. Backward multiple linear regression analysis identified the proportion of Muslims, physicians density, and adolescent fertility rate are as the three most prominent factors linked with the national HIV epidemic. Conclusions: The findings support the hypotheses that a higher adolescent fertility rate in the population is the adverse effect of premarital and extramarital sex that leads to longer period of sexual activity which increases the risk of HIV infection. On the hand, and cultural restrictions of Muslims and sufficient physicians will decelerate the spread of HIV infections in the society.

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“…The impact of HIV and ART on contraceptive use varies between settings [15,16]. Increased contraceptive uptake has been reported in response to HIV diagnosis or ART initiation [18,19,23].…”

mentioning

confidence: 99%

Influence of Culture on Contraceptive Utilization Among HIV-Positive Women in Brazil, Kenya, and South Africa

Todd

Stibich²,

Laher

et al. 2010

AIDS Behav

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Contraceptive choice and discontinuation are poorly understood among HIV-positive women, and HIV disease and culture may influence decisions. We assessed factors influencing contraceptive decision-making among HIV-positive women in three countries. This qualitative assessment of 108 HIV-positive women (36/site, selected by age and parity strata) was conducted in Rio de Janeiro, Brazil; Kericho, Kenya; and Soweto, South Africa. Freelist interviews assessed knowledge and attitudes towards contraception and were analyzed enumerating frequency and saliency of mentions. There was intersite consensus around list items but priority and themes varied. Site-specific factors influencing contraceptive choice were male partner wishes and fertility desire (Brazil), side-effects (South Africa), and impact on health and HIV progression (Kenya). Age, parity, and taking antiretroviral therapy (ART) impacted some themes. Contraceptive use among HIV-positive women is substantially influenced by culture and other factors. Counseling efforts should consider individual factors in method selection and offer method variety to accommodate changing needs.

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A Qualitative Assessment of Decisions Affecting Contraceptive Utilization and Fertility Intentions among HIV-Positive Women in Soweto, South Africa

Cited by 60 publications

References 30 publications

Fertility Decision-Making Among Kenyan HIV-Serodiscordant Couples Who Recently Conceived: Implications for Safer Conception Planning

Fertility Decision-Making Among Kenyan HIV-Serodiscordant Couples Who Recently Conceived: Implications for Safer Conception Planning

Factors affecting the HIV/AIDS epidemic: An ecological analysis of global data

Influence of Culture on Contraceptive Utilization Among HIV-Positive Women in Brazil, Kenya, and South Africa

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