Reproductive decision-making and periconception practices among HIV-positive men and women attending HIV services in Durban, South Africa.
Understanding reproductive decisions and periconception behavior among HIV-discordant couples is important for designing risk reduction interventions for couples who choose to conceive. In-depth interviews were conducted to explore reproductive decision-making and periconception practices among HIV-positive women with recent pregnancy (n = 30), and HIV-positive men (n = 20), all reporting partners of negative or unknown HIV-status, and attending HIV services in Durban, South Africa. Transcripts were coded for categories and emergent themes. Participants expressed strong reasons for having children, but rarely knew how to reduce periconception HIV transmission. Pregnancy planning occurred on a spectrum ranging from explicitly intended to explicitly unintended, with many falling in between the two extremes. Male fertility desire and misunderstanding serodiscordance contributed to HIV risk behavior. Participants expressed openness to healthcare worker advice for safer conception and modified risk behavior post-conception, suggesting the feasibility of safer conception interventions which may target both men and women and include serodiscordance counseling and promotion of contraception.
Division of Infectious Diseases and Center for Global Health, Massachusetts General Hospital, Boston, MA 02114, USA. ltmatthews@partners.org
Lynn T
LT
Matthews
Tamaryn
T
Crankshaw
Janet
J
Giddy
Angela
A
Kaida
Jennifer A
JA
Smit
Norma C
NC
Ware
David R
DR
Bangsberg
D000328:Adult; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D003376:Counseling / Q000379:methods; D003657:Decision Making; D005193:Family Planning Services; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D012309:Risk-Taking; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires