Role of HIV in the desire of procreation and motherhood in women living with HIV in Spain: a qualitative approach

Abstract

BackgroundImproved antiretroviral treatments and decrease in vertical transmission of HIV have led to a higher number of women living with HIV to consider childbearing. However, stigma and social rejection result in specific challenges that HIV positive women with procreation intentions have to face with. Our objective was to in depth analyse elements shaping their desire for procreation and specifically investigate the impact of HIV.MethodsA qualitative study was conducted through open interviews with 20 women living with HIV between 18 and 45 years of age, from the Spanish AIDS Research Network Cohort (CoRIS). Interviews were audio-recorded and transcribed. A content analysis was performed.ResultsHIV diagnosis is a turning point in women’s sexual and emotional life that is experienced traumatically. HIV diagnosis is usually associated with the fear of an immediate death and the idea of social isolation. At this moment, women temporarily reject future motherhood or having a sexual life. HIV status is only disclosed to the closed social circle and partner support is essential in HIV diagnosis assimilation process. Health professionals provide information on assisted reproductive technology and on how to minimize risk of partner HIV transmission. Most of barriers for procreation acknowledged by women are not related to HIV. However, women fear vertical transmission and experience other barriers derived from HIV infection. In this context, pregnancy makes women feel themselves as “normal women” despite HIV. Motherhood is considered an element of compensation that helps them to cope with HIV diagnosis. All these elements make health professionals key actors: they provide information and support after HIV diagnosis.ConclusionsBarriers and drivers for procreation are similar among HIV positive women and general population. However, stigma and discrimination linked with HIV weigh in HIV positive women decision of motherhood. In this context, it is necessary to provide these women with the necessary counselling, guidance and resources to take decisions about procreation properly informed.Electronic supplementary materialThe online version of this article (10.1186/s12905-017-0483-y) contains supplementary material, which is available to authorized users.

Factors associated with childbearing intention of women on Antiretroviral Therapy in Northwest Ethiopia: A cross sectional study

“…Women who have alive children were less likiliy to have childbearing intention than women who have no alive child .This nding is agreed with previous ndings from Finoteselam Hospital(28),Addis Ababa (38),South west Ethiopia (39), Ethiopia(40), South Africa (33), Malawi (26),Tanzania (21) .This could be discrimative attitude face by the mother i.e. 48% of women thought that children living with HIV should not be able to attend school with children who are HIV negative (41),fear of stigma and discrimination (42). The other reason could be fear of mother to child transmission, care of alive child.…”

Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

“…They described how HIV assaulted their bodies; stole their sense of beauty, and left the perception of dirtiness [ 61 ]. HIV was a barrier present everywhere and all the time [ 61 , 98 – 100 ] “Ah, it’s just always in the bedroom, HIV. It’s always there.” [ 98 ] "…when I looked at myself in the mirror, I could see around me the shadow of the virus (...).…”

“…It was horrible because I was disgusted by myself. I looked at myself in the mirror and I could see around me, literally, a grey shadow ... And I thought “this is the virus.” [ 100 ]…”

Semi-parametric model for timing of first childbirth after HIV diagnosis among women of childbearing age in Ibadan, Nigeria

“…Despite most women having at least one child at the time of HIV diagnosis, nearly half had first birth after HIV diagnosis. This result buttresses the importance of motherhood as a means of coping with HIV diagnosis [10], and the need to integrate reproductive counselling into HIV treatments and care in Nigeria. Although the available literature reported one-quarter of women being pregnant after HIV diagnosis in Canada [9], the percentage of women having at least a child after https://doi.org/10.1371/journal.pone.0240247.g001…”

“…Meanwhile, a long duration on ART has been established to influence women's desire for children [7]. Even in the era of effective ART, empirical studies have established that HIV diagnosis may significantly influence women's decision and timing to have the next child birth or otherwise [8][9][10][11]. Child's birth may boost motherhood status among WLWH.…”