title: Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.
abstract: OBJECTIVE
  In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing.
  
  
  METHODS
  In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV.
  
  
  RESULTS
  Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'.
  
  
  CONCLUSIONS
  Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women.
  
  
  CONCLUSIONS
  These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting.
authors.affiliation: Department of Social Work and Social Administration, Makerere University Kampala, Uganda. Electronic address: dnyanzi@hotmail.com.
authors.forename: Ismael
authors.initials: I
authors.lastname: Ddumba-Nyanzi
authors.affiliation: Department of Social Work and Social Administration, Makerere University Kampala, Uganda. Electronic address: mafigiridk@yahoo.com.
authors.forename: David
authors.initials: D
authors.lastname: Kaawa-Mafigiri
authors.affiliation: Department of Public Health, University of Southern Denmark, Denmark. Electronic address: Hjohannessen@health.sdu.dk.
authors.forename: Helle
authors.initials: H
authors.lastname: Johannessen
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003142:Communication; D003376:Counseling; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D010817:Physician-Patient Relations; D016742:Preconception Care; D011247:Pregnancy; D036301:Qualitative Research; D043762:Reproductive Behavior; D012725:Sexual Behavior; D014454:Uganda
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antiretroviral treatment; HIV/AIDS; Reproductive counseling; Sexual responsibility; Uganda