title: A qualitative assessment of decisions affecting contraceptive utilization and fertility intentions among HIV-positive women in Soweto, South Africa.
abstract: The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women.
authors.affiliation: Perinatal HIV Research Unit, University of the Witwatersrand, Diepkloof, P.O. Box 114, Johannesburg, Soweto, 1864, South Africa. laherf@hivsa.com
authors.forename: Fatima
authors.initials: F
authors.lastname: Laher
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Todd
authors.forename: Mark A
authors.initials: MA
authors.lastname: Stibich
authors.forename: Rebecca
authors.initials: R
authors.lastname: Phofa
authors.forename: Xoliswa
authors.initials: X
authors.lastname: Behane
authors.forename: Lerato
authors.initials: L
authors.lastname: Mohapi
authors.forename: Glenda
authors.initials: G
authors.lastname: Gray
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003268:Contraception Behavior; D003657:Decision Making; D005260:Female; D005298:Fertility; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D011247:Pregnancy; D036301:Qualitative Research; D013019:South Africa; D016387:Women's Health