title: Sexual relations and childbearing decisions of HIV-discordant couples: an exploratory study in South Africa and Tanzania.
abstract: This article reports on the influence of HIV on sexual relations and childbearing decisions of 36 HIV-discordant couples, 26 in South Africa and 10 in Tanzania, recruited into an exploratory study through hospital antiretroviral treatment clinics and civil society organisations working with people living with HIV. Self-administered questionnaires were used to obtain social and demographic information, while couples' sexual relations and childbearing decisions were explored through in-depth, semi-structured individual and couple interviews. The majority of the HIV-positive partners were women, who were on antiretroviral treatment. Almost one-third of South African respondents and half of those in Tanzania reported experiences of tension related to HIV-discordance, while more than half of the South Africans and almost three-quarters of the Tanzanians reported that intimacy had been affected by their discordant status. Those without children were more likely to desire children (17/23) than those who already had children (16/44), although this desire was influenced by fear of HIV transmission to the negative partner and medical professional advice. The study points to the need for targeted information for HIV discordant couples, as well as couple counselling and support services.
authors.affiliation: Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. laetitia.rispel@wits.ac.za
authors.forename: Laetitia C
authors.initials: LC
authors.lastname: Rispel
authors.forename: Carol A
authors.initials: CA
authors.lastname: Metcalf
authors.forename: Kevin
authors.initials: K
authors.lastname: Moody
authors.forename: Allanise
authors.initials: A
authors.lastname: Cloete
authors.forename: Georgina
authors.initials: G
authors.lastname: Caswell
mesh_terms: D000328:Adult; D003075:Coitus / Q000523:psychology*; D005193:Family Planning Services / Q000379:methods; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D021841:Safe Sex / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology