Ethics, Ideology, and Reproductive Health Policy in the United States

Kulczycki, Andrzej

doi:10.1111/j.1728-4465.2007.00145.x

Cited by 26 publications

(13 citation statements)

References 70 publications

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“…We hope that our research and ongoing projects assist HIV-positive individuals, policy makers and healthcare providers globally to develop their programs for safer, supportive pregnancy planning for HIV-positive individuals in their communities. Although much research has been started on a global level in the area of safer pregnancy planning, fertility, pregnancy, and parenting [49]–[56], significantly more is needed to support HIV-positive individuals to have healthy pregnancies and families. Finally, similar research should be carried out with HIV-positive male populations, which is being planned by our research team.…”

Section: Discussionmentioning

confidence: 99%

Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study

et al. 2009

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BackgroundImprovements in life expectancy and quality of life for HIV-positive women coupled with reduced vertical transmission will likely lead numerous HIV-positive women to consider becoming pregnant. In order to clarify the demand, and aid with appropriate health services planning for this population, our study aims to assess the fertility desires and intentions of HIV-positive women of reproductive age living in Ontario, Canada.Methodology/Principal FindingsA cross-sectional study with recruitment stratified to match the geographic distribution of HIV-positive women of reproductive age (18–52) living in Ontario was carried out. Women were recruited from 38 sites between October 2007 and April 2009 and invited to complete a 189-item self-administered survey entitled “The HIV Pregnancy Planning Questionnaire” designed to assess fertility desires, intentions and actions. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios of significant predictors of fertility intentions. The median age of the 490 participating HIV-positive women was 38 (IQR, 32–43) and 61%, 52%, 47% and 74% were born outside of Canada, living in Toronto, of African ethnicity and currently on antiretroviral therapy, respectively. Of total respondents, 69% (95% CI, 64%–73%) desired to give birth and 57% (95% CI, 53%–62%) intended to give birth in the future. In the multivariable model, the significant predictors of fertility intentions were: younger age (age<40) (p<0.0001), African ethnicity (p<0.0001), living in Toronto (p = 0.002), and a lower number of lifetime births (p = 0.02).Conclusions/SignificanceThe proportions of HIV-positive women of reproductive age living in Ontario desiring and intending pregnancy were higher than reported in earlier North American studies. Proportions were more similar to those reported from African populations. Healthcare providers and policy makers need to consider increasing services and support for pregnancy planning for HIV-positive women. This may be particularly significant in jurisdictions with high levels of African immigration.

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Section: Discussionmentioning

confidence: 99%

Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study

et al. 2009

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“…The promotion of inaccurate information about abortion has been identified in abstinence-only education (AOE) programmes (Ott and Santelli 2007) and Crisis Pregnancy Centers (CPCs) (Bryant and Levi 2012;Rosen 2012), both of which tend to exaggerate the health risks of abortion, specifically depression, breast cancer and infertility (Russo and Denious 2005;Kulczycki 2007;Mauro and Joffe 2007). 4 Of the 17 states requiring AOE programmes, just over half (53%) were 'red' states (Stanger-Hall, Hall, and Vitzthum 2011), while the majority of the 25 states that rejected federal funding for AOE were 'blue' states, as of 2009 (Sexuality Information and Education Council of the United States 2011).…”

Section: Differences In State Abortion Laws and Policiesmentioning

confidence: 99%

Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the ‘red states v. blue states’ hypothesis

Bessett

Gerdts

Littman

et al. 2015

Culture, Health & Sexuality

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Recently, the hypothesis that state-level political context influences individuals' cultural values--the 'red states v. blue states' hypothesis--has been invoked to explain the hyper-polarisation of politics in the USA. To test this hypothesis, we examined individuals' knowledge about abortion in relation to the political context of their current state of residence. Drawing from an internet-survey of 586 reproductive-age individuals in the USA, we assessed two types of abortion knowledge: health-related and legality. We found that state-level conservatism does not modify the existing relationships between individual predictors and each of the two types of abortion knowledge. Hence, our findings do not support the 'red states' versus 'blue states' hypothesis. Additionally, we find that knowledge about abortion's health effects in the USA is low: 7% of our sample thought abortion before 12 weeks gestation was illegal.

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“…Although limited thus far, such linkages are starting to be developed in several international organizations and countries, including Canada [20][21][22][23][24][25][26][27][28]. HIV status at the time of the last pregnancy, ethnic background, marital status and number of lifetime births were the variables retained in the multivariable model, as the two former covariates were the a priori covariates of interest and the latter two were statistically significant.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of unintended pregnancies in HIV‐positive women of reproductive age in Ontario, Canada: a retrospective study

et al. 2011

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There is speculation, but there are few data, on the high rates of unintended pregnancies in HIV-positive women. We investigated rates and correlates of unintended pregnancies among HIV-positive women of reproductive age. MethodsA cross-sectional study was conducted with recruitment stratified to match the geographical distribution of HIV-positive women of reproductive age (18-52 years) living in Ontario, Canada. Women, recruited from 38 sites between October 2007 and April 2009, were invited to complete a 189-item self-administered survey. This analysis focused on questions relating to pregnancy and whether the last pregnancy was intended. Logistic regression models were fitted to calculate unadjusted and adjusted odds ratios of correlates of unintended pregnancies occurring after HIV diagnosis. Happiness with unintended pregnancies was also assessed. ResultsThe median age at the time of the survey of the 416 participating HIV-positive women who were previously pregnant (53% before and 47% after HIV diagnosis) was 38 years [interquartile range (IQR) 33-44 years] and their last pregnancy was a median of 8 years (IQR 3-14 years) prior to the survey (n 5 283). Fifty-nine per cent were born outside Canada and 47% were of African ethnicity. Of the 416, 56% [95% confidence interval (CI) 51-61%] identified that their last pregnancy was unintended (57% before and 54% after HIV diagnosis). In the multivariable model, significant correlates of unintended pregnancy after HIV diagnosis were: marital status (P 5 0.01) and never having given birth (P 5 0.01). Women were less happy if their pregnancy was unintended (Po0.01). ConclusionsThe prevalence of unintended pregnancy was high in this cohort. Pregnancy planning programmes are needed for this population to decrease fetal and maternal complications and reduce vertical and horizontal transmission.

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Ethics, Ideology, and Reproductive Health Policy in the United States

Cited by 26 publications

References 70 publications

Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study

Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study

Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the ‘red states v. blue states’ hypothesis

High prevalence of unintended pregnancies in HIV‐positive women of reproductive age in Ontario, Canada: a retrospective study

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