Patterns of changing pregnancy intentions among women living with HIV in Canada

Skerritt, Lashanda; Kaida, Angela; O’Brien, Nadia; Burchell, Ann; Bartlett, Gillian; Savoie, Édénia; Boucoiran, Isabelle; Gormley, Rebecca; Kestler, Mary; Money, Deborah; Loutfy, Mona; Pokomandy, Alexandra de

doi:10.1186/s12905-021-01492-1

Cited by 6 publications

(7 citation statements)

References 52 publications

(66 reference statements)

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“… 52 Such intentions are highly dynamic with two-fifths of women changing their pregnancy intentions within 3 years of follow-up. 53 Despite these varying reproductive intentions, nearly half of women living with HIV had never discussed their reproductive goals with a healthcare provider since being diagnosed with HIV. 52 Also, 42% reported they did not currently have a healthcare provider they felt comfortable speaking to about reproductive goals.…”

Section: Methodsmentioning

confidence: 99%

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

Kaida

Cameron²,

Conway³

et al. 2022

Womens Health (Lond Engl)

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Action on the World Health Organization Consolidated guideline on sexual and reproductive health and rights of women living with HIV requires evidence-based, equity-oriented, and regionally specific strategies centred on priorities of women living with HIV. Through community–academic partnership, we identified recommendations for developing a national action plan focused on enabling environments that shape sexual and reproductive health and rights by, with, and for women living with HIV in Canada. Between 2017 and 2019, leading Canadian women’s HIV community, research, and clinical organizations partnered with the World Health Organization to convene a webinar series to describe the World Health Organization Consolidated guideline, define sexual and reproductive health and rights priorities in Canada, disseminate Canadian research and best practices in sexual and reproductive health and rights, and demonstrate the importance of community–academic partnerships and meaningful engagement of women living with HIV. Four webinar topics were pursued: (1) Trauma and Violence-Aware Care/Practice; (2) Supporting Safer HIV Disclosure; (3) Reproductive Health, Rights, and Justice; and (4) Resilience, Self-efficacy, and Peer Support. Subsequent in-person (2018) and online (2018–2021) consultation with > 130 key stakeholders further clarified priorities. Consultations yielded five cross-cutting key recommendations: 1. Meaningfully engage women living with HIV across research, policy, and practice aimed at advancing sexual and reproductive health and rights by, with, and for all women. 2. Centre Indigenous women’s priorities, voices, and perspectives. 3. Use language that is actively de-stigmatizing, inclusive, and reflective of women’s strengths and experiences. 4. Strengthen Knowledge Translation efforts to support access to and uptake of contemporary sexual and reproductive health and rights information for all stakeholders. 5. Catalyse reciprocal relationships between evidence and action such that action is guided by research evidence, and research is guided by what is needed for effective action. Topic-specific sexual and reproductive health and rights recommendations were also identified. Guided by community engagement, recommendations for a national action plan on sexual and reproductive health and rights encourage Canada to enact global leadership by creating enabling environments for the health and healthcare of women living with HIV. Implementation is being pursued through consultations with provincial and national government representatives and policy-makers.

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Section: Methodsmentioning

confidence: 99%

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

Kaida

Cameron²,

Conway³

et al. 2022

Womens Health (Lond Engl)

Self Cite

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“…We believe that discussions about pregnancy should not need to wait until a woman asks her physician or nurse, but should be proactively started by healthcare providers. Previous research has found that reproductive discussions are not routine and account for the largest measured gap in comprehensive healthcare for WLWH [35].…”

Section: Discussionmentioning

confidence: 99%

Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV

et al. 2023

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Objectives To describe prevalence and factors associated with unplanned pregnancies, and social and partner support during pregnancy among women from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods We included all women recruited in CoRIS from 2004 to 2019, aged 18–50 years at recruitment who were pregnant during 2020. We designed a questionnaire, organized into the following domains: sociodemographic characteristics, tobacco and alcohol consumption, pregnancy and reproductive health, and social and partner support. The information was gathered via telephone interviews conducted from June to December 2021. We calculated prevalence of unplanned pregnancies as well as odds ratios (ORs) of association and 95% confidence intervals (CIs) according to sociodemographic, clinical and reproductive characteristics. Results Among 53 women who were pregnant during 2020, 38 (71.7%) answered the questionnaire. Median age at pregnancy was 36 years [interquartile range (IQR) 31–39], 27 (71.1%) women were born outside of Spain, mainly in sub‐Saharan Africa (39.5%) and 17 (44.7%) were employed. Thirty‐four (89.5%) women had been through previous pregnancies and 32 (84.2%) had experienced previous abortions/miscarriages. Seventeen (44.7%) women had shared with their clinician their desire to get pregnant. Thirty‐four (89.5%) pregnancies were natural and four used assisted reproductive techniques (in vitro fertilizations; one additionally used oocyte donation). Of 34 women with natural pregnancies, pregnancy was unplanned in 21 (61.8%) and 25 (73.5%) had information on how to become pregnant avoiding HIV transmission to the baby and partner. Women who did not seek advice from their physician about becoming pregnant had a significantly increased risk of unplanned pregnancy (OR = 71.25, 95% CI: 8.96–566.67). Overall, 14 (36.8%) women reported having low social support during pregnancy and 27 (71.0%) had good/very good support by their partner. Conclusions Most pregnancies were natural and unplanned and very few women had talked with their clinician about their desire to become pregnant. A high proportion of women reported low social support during pregnancy.

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“…No significant association was observed between demographic-socio-economic characteristics and fertility intention. Previous studies, on the other hand, showed a close link between gender and perceived stigma from healthcare providers [ 8 , 23 , 24 ]. These disparities by gender also could have accounted for the stronger association among the husbands compared to the wives.…”

Section: Discussionmentioning

confidence: 99%

“…In Chinese society and culture, wives are primarily reliant on their husbands for fertility [25][26][27]. Furthermore, it seems that the wives' fertility intention was more influenced by the efforts of their husbands to address stigma, fertility desire, and fertility intention [24,28] than from other factors. Only minor differences were found in fertility intention between HIV-positive versus HIVnegative husbands.…”

Section: Plos Onementioning

confidence: 99%

Mediation of the association between stigma and HIV status and fertility intention by fertility desire among heterosexual couples living with HIV in Kunming, China

Guo

Wichaidit

et al. 2022

PLoS ONE

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Objectives This study aimed to assess the influences of stigma and HIV status on reproductive intention among heterosexual couples living with HIV in China. Methods A cross-sectional study was conducted in Kunming, China among 315 HIV-positive individuals and their spouses (n = 315 couples). An interview questionnaire was used to collect data on intention, desire, HIV Stigma Scale items, and HIV status. Dyadic fertility intention was examined using the actor-partner interdependence mediation model, based on the Traits-Desires-Intentions-Behavior framework. Results The husbands’ or wives’ internalized stigma had significant negative effects on their own fertility desire (β = −0.149, p<0.05 and β = −0.238, p<0.01, respectively). HIV-positive status of the husbands was weakly linked to their own fertility intention (β = −0.181, p<0.05). Husbands’ perceived provider stigma was associated with their own and their wives’ fertility intention via the mediating effect of their fertility desire (β = −0.374, p<0.001 and β = −0.203, p<0.01, respectively). The cumulative influence of their reproductive desire mediated the husband’s perceived provider stigma and the wife’s internalized stigma on their fertility intention. Conclusions Stigma and HIV status were associated with fertility intention among couples living with HIV, mediated by fertility desire. The high intra-couple correlation suggested that counseling should be conducted when both spouses are present together with extensive discussions on concerns regarding HIV-related stigma, potential discrepancies between each partner’s fertility desire and intention, and the influence of one partner on the other.

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Patterns of changing pregnancy intentions among women living with HIV in Canada

Cited by 6 publications

References 52 publications

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV

Mediation of the association between stigma and HIV status and fertility intention by fertility desire among heterosexual couples living with HIV in Kunming, China

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