HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

S, Finocchario Kessler; Bastos, Francisco I.; Malta, Mônica; Bertoni, Neilane; Hanif, Homaira; Kerrigan, Deanna

doi:10.1089/apc.2013.0354

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…According to the search strategy we retrieved 5,314 articles, of which 1,795 were duplicates. Finally, 50 articles were assessed for eligibility in these meta-analyses after full-text screening [ 10 , 14 , 27 – 74 ]. A flowchart of the literature search was presented in Fig 1 .…”

Section: Resultsmentioning

confidence: 99%

Prevalence and factors associated with fertility desire among people living with HIV: A systematic review and meta-analysis

Yan

Du²,

2021

PLoS ONE

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Background The fertility desire of people living with HIV (PLHIV) has been rising in the past decade. However, there are many studies among which the association remains controversial between the fertility desire of HIV-infected persons and antiretroviral therapy (ART), sex, marital status, and educational level. Methods We performed a literature search of these meta-analyses in PubMed, the Cochrane Library, Web of Science and ScienceDirect in November 2019. We also reviewed references of eligible studies to complement the search. We used pooled odds ratios (ORs) and 95% confidence intervals (CIs) with a random-effects model and a fixed-effects model to estimate the association between fertility desire among PLHIV and ART, sex, age, marital status, educational level, and number of children. Subgroups with I square values (I2) and sensitivity analyses were performed to assess the heterogeneity and the stability of the overall ORs, respectively. We evaluated publication bias using Egger’s test and a visual inspection of the symmetry in funnel plots. Results In these meta-analyses 50 articles were included with 22,367 subjects. The pooled prevalence of fertility desire among PLHIV was estimated to be 42.04%. The pooled analyses showed that the fertility desire of PLHIV is associated with ART (OR = 1.11, 95% CI:1.00–1.23, P = 0.043), sex (OR = 1.51, 95% CI:1.10–2.09), age (OR = 2.65, 95% CI:2.24–3.14), marital status (OR = 1.34, 95% CI:1.08–1.66), educational level (OR = 0.85, 95% CI:0.73–1.00, P = 0.047) and the number of children (OR = 3.99, 95% CI:3.06–5.20). PLHIV who are on ART, are male, are younger than 30, are married/cohabiting, have received a secondary education or above, and are childless have a higher prevalence of fertility desire. The two factors of age and the number of children, in particular demonstrated a strong significant association with fertility desire. We found moderate heterogeneity in the meta-analyses of age and educational level and high heterogeneity in the meta-analyses of sex, marital status and number of children. Publication bias was detected in the meta-analyses of the association of fertility with sex and educational level. Conclusion This study demonstrates that the prevalence of fertility desire among HIV-infected people is 42.04%, and the fertility desire among PLHIV is associated with ART experience, sex, age, marital status, the number of children, and educational level. Since a majority of PLHIV are of reproductive age, it is necessary to support PLHIV in terms of their needs regarding reproductive decision-making. Through counseling and reproductive health care, further measures to prevent the horizontal and vertical transmission of HIV should be taken.

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Section: Resultsmentioning

confidence: 99%

Prevalence and factors associated with fertility desire among people living with HIV: A systematic review and meta-analysis

Yan

Du²,

2021

PLoS ONE

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“…Most often it was female patients who initiated these conversations, despite the fact that both partners should be involved in decision making and planning. 36 , 37 …”

Section: Discussionmentioning

confidence: 99%

Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers

Goggin

Finocchario-Kessler

Staggs

et al. 2015

AIDS Patient Care and STDs

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High rates of childbearing desires (59%) and serodiscordant partnerships (50%) among people living with HIV (PHLA) in Uganda highlight the need for safer conception counseling (SCC). Provider attitudes about counseling PLHA on the use of safer conception methods (SCM) have been explored in qualitative studies, but published quantitative investigations are scarce. Data from 57 Ugandan providers were collected to examine providers' attitudes about childbearing among PLHA and engagement in discussions about childbearing, as well as their knowledge, interest, self-efficacy, and intentions to provide SCC. Correlates of self-efficacy for the provision of SCC were explored to inform the development of training programs. Providers reported a general awareness of most SCM, especially timed unprotected intercourse (TUI); but just over half felt they knew enough to counsel clients in the future and all wanted more training. Childbearing was discussed with less than a third of reproductive aged patients and was mostly initiated by patients. Most providers saw value in providing SCC and believed that most aspects of SCM would be acceptable to their clients, but numerous barriers were endorsed. Self-efficacy was greatest among providers who had had more childbearing conversations, greater SCM awareness, perceived fewer barriers and greater intentions to counsel on TUI. Providers evidence fewer stigmatizing attitudes than in the past. However, those who endorsed more stigmatizing attitudes evidenced a trend for reporting lower self-efficacy for providing SCC. Training will need to simultaneously focus on increasing providers' SCC knowledge and skills while instilling a more realistic appraisal of the risks of assisting couples to employ SCM versus doing nothing.

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“…In a recent study, 31% of HIV-infected men and women in care in Uganda reported wanting to have children, yet nearly two-thirds had never discussed their fertility desires with a provider [ 5 ]. Globally, client conversations with HIV care providers about pregnancy plans are infrequent, as shown in studies from sub-Saharan Africa [ 16 – 20 ], South America [ 21 – 23 ], North America [ 24 – 26 ], and Europe [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“I Always Worry about What Might Happen Ahead”: Implementing Safer Conception Services in the Current Environment of Reproductive Counseling for HIV-Affected Men and Women in Uganda

Matthews

Bajunirwe

Kastner

et al. 2016

BioMed Research International

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Background. We explored healthcare provider perspectives and practices regarding safer conception counseling for HIV-affected clients. Methods. We conducted semistructured interviews with 38 providers (medical and clinical officers, nurses, peer counselors, and village health workers) delivering care to HIV-infected clients across 5 healthcare centres in Mbarara District, Uganda. Interview transcripts were analyzed using content analysis. Results. Of 38 providers, 76% were women with median age 34 years (range 24–57). First, we discuss providers' reproductive counseling practices. Emergent themes include that providers (1) assess reproductive goals of HIV-infected female clients frequently, but infrequently for male clients; (2) offer counseling focused on “family planning” and maternal and child health; (3) empathize with the importance of having children for HIV-affected clients; and (4) describe opportunities to counsel HIV-serodiscordant couples. Second, we discuss provider-level challenges that impede safer conception counseling. Emergent themes included the following: (1) providers struggle to translate reproductive rights language into individualized risk reduction given concerns about maternal health and HIV transmission and (2) providers lack safer conception training and support needed to provide counseling. Discussion. Tailored guidelines and training are required for providers to implement safer conception counseling. Such support must respond to provider experiences with adverse HIV-related maternal and child outcomes and a national emphasis on pregnancy prevention.

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HIV+ Men Need Reproductive Counseling Too: Assessing Childbearing Goals and Provider Communication Among HIV+ Male Patients in Rio de Janeiro, Brazil

Cited by 8 publications

References 26 publications

Prevalence and factors associated with fertility desire among people living with HIV: A systematic review and meta-analysis

Prevalence and factors associated with fertility desire among people living with HIV: A systematic review and meta-analysis

Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers

“I Always Worry about What Might Happen Ahead”: Implementing Safer Conception Services in the Current Environment of Reproductive Counseling for HIV-Affected Men and Women in Uganda

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