Access to conception planning information and services for people living with HIV in Ontario, Canada: A community-based research study

Abstract

Decreased mortality, decreased risk of vertical HIV transmission, and many people living with HIV (PLWHIV) being of reproductive age have led many PLWHIV to consider pregnancy. However, scarce data exist regarding the conception planning resources required and available for PLWHIV to have safe and healthy pregnancies. This study aimed to identify gaps between the need for, knowledge of, and access to conception planning information and services among PLWHIV in Ontario, Canada. PLWHIV from three large and two small urban sites in Ontario were recruited (n = 63). Participants completed a cross-sectional survey assessing demographics, expectations and plans for conception, and knowledge about and access to existing conception information and services for PLWHIV. Univariate correlations and ranked analyses were used to assess the associations between the need for, knowledge of, and access to conception planning resources with various demographic variables. Participants' median age was 40 years (interquartile range = 33-45) with 52% being female, 73% identified as heterosexual, and 27% as lesbian, gay, bisexual, queer, transgender, two-spirited, or other. Univariable analysis indicated that male PLWHIV and those from small urban areas were less likely to expect children in the future and less likely to speak to healthcare providers about conception planning. Although 63% of all participants intended to conceive and 44% had a plan for conception in the near future, only 30% had spoken to a healthcare provider about pregnancy and only 30% had some knowledge about conception planning and assisted reproductive services for safer conception for PLWHIV. Knowledge of and access to resources on conception planning for PLWHIV varied by sexual orientation and geographic location in Ontario. Our results show a gap between the need for conception information and knowledge of and access to adequate information and resources among PLWHIV in Ontario, which may impact the psychosocial well-being of PLWHIV and their children.

Examining preconception care-related knowledge and attitudes among Chinese immigrants in Canada

“…Although several studies examined preconception health knowledge and behaviors among some groups in Canada, such as regional childbearing-aged residents (Best Start Resource Centre, 2009b;Einarson and Koren, 2006;Tough et al, 2007), women at high risk (Huynh et al, 2012;Lipscombe et al, 2011;Murphy et al, 2010), immigrant women as a whole (Han et al, 2009), and health care providers (Best Start Resource Centre, 2009c;Ng and Newbold, 2011;Suzanne, 2004), Chinese immigrants' preconception health issues have not been well documented in the literature. Therefore, to examine the knowledge and attitudes/beliefs toward preconception health care among the Chinese immigrants in Canada, and to identify significant variables that may influence their behaviors related to preconception health and barriers that may prevent the use of preconception care, the following research questions are posed: Theoretical framework: the health belief model (HBM)…”

“…Guided by it, public health units implemented a series of province-wide strategies to promote preconception health across Canada, including awareness campaigns, resource releases, and education classes (Best Start Resource Centre, 2009a). Also, some research has been conducted to determine the degree to which preconception health care has been perceived by different target groups in Canada, such as regional childbearing-aged residents (Best Start Resource Centre, 2009b;Einarson and Koren, 2006;Tough et al, 2007), women at high risk (Huynh et al, 2012;Lipscombe et al, 2011;Murphy et al, 2010), and health care providers (Ng and Newbold, 2011). However, most of these studies do not pay attention to ethnic minority populations, and as such, very little is known about the viewpoints of these population groups in relation to reproductive health issues.…”

A review of reproductive health research, guidelines and related gaps for women living with HIV

“…There is a lack of information about conception planning and pregnancy for those wishing to have children (Huynh et al, 2012). Ndlovu et al (2009) found evidence of inadequate knowledge among people living with HIV (PLWHIV) about pregnancy, despite having regular access to a healthcare professional, and reported that ethnicity influenced the degree of knowledge.…”

“…Ndlovu et al (2009) found evidence of inadequate knowledge among people living with HIV (PLWHIV) about pregnancy, despite having regular access to a healthcare professional, and reported that ethnicity influenced the degree of knowledge. PLWHIV and healthcare providers globally have indicated that access to clinical guidelines, pamphlets, workshops and peer-counselling and support are important tools to optimise the care of PLWHIV during preconception and conception (Fakoya et al, 2008; Huynh et al, 2012). Preconception and conception guidelines currently available across Europe, Canada and USA are outlined in Table 2.…”

‘Before HIV you're a human being’ – PLWHA and reproduction in Jamaica

“…However, both guidelines acknowledge that facilities for safe reproduction for PLWHA are limited and the capacity to provide support is insufficient (Fakoya et al 2008, Loutfy et al 2012a. Several literature reviews have likewise identified a gap between the reproductive needs of PLWHA and service provision in North America, Australia and the UK (Fakoya et al 2008, Huynh et al 2012Loutfy et al 2012aLoutfy et al , 2012b Overall, within HIV programmes around the world, there is a historic lack of recognition of PLWHA's reproductive needs and the importance of reproduction to many adult gender roles. Even in the regions where this recognition is present health services are struggling to adjust and provide appropriate services.…”