Fertility preferences and the need for contraception among women living with HIV: the basis for a joint action agenda

Abstract

HIV-positive women who know their serostatus exhibit fertility desires and contraceptive behaviors that are different from those of other women. These findings support the argument that efforts to scale up the second element of the strategy to prevent mother-to-child transmission of HIV should be accelerated: it is a cost-effective, rights-based approach to preventing incidence of mother-to-child transmission of HIV. Scaling up requires full commitment by both reproductive health/family planning and HIV constituencies to concerted integration at all levels of program planning, coordination and implementation.

HIV/AIDS and contraceptive use: factors associated with contraceptive use among sexually active HIV-positive women in Kenya

“…This is consistent with existing sociological theories which have long recognized that an individual's health-seeking behavior is influenced not only by individual risk factors, but also by the social context/environment. [25,26] The observed positive association between perceived HIV risk and contraceptive uptake is consistent with previous studies which suggest that being HIV-positive is associated with increased desire to stop childbearing, [4,6] an important predictor of contraceptive uptake.…”

“…[1,2] It has been noted that HIV-positive women have special concerns regarding family planning, which calls for research to better understand contraceptive behavior and needs of women living with HIV. [3] Many HIV-positive women desire to stop childbearing and prevent pregnancy, [4,5,6] but unintended pregnancies are as common among this group as among HIV-negative women. [7,8,9] Unintended pregnancies among HIV-positive women are of particular concern as this poses risks for maternal and child health.…”

Differences in Unintended Pregnancy, Contraceptive Use and Abortion by HIV Status Among Women in Nigeria and Zambia

“…This association lends support to previous studies. 10,11,56 Although this article examines associations rather than causal relationships, it is noteworthy that the majority (65%) of respondents of known status who had an unintended pregnancy had had their last HIV test prior to their unintended pregnancy, while a further 24% had had it in the same year as their pregnancy. It is therefore plausible that test results could be influencing the likelihood of experiencing an unintended pregnancy for most of the respondents.…”

“…6 The HIV epidemic is having a profound and complex effect on reproductive behavior in Africa. A desire for fewer children among HIV-positive women than among HIV-negative women or women of unknown status has been documented both in cross-sectional studies [7][8][9][10][11][12] and in longitudinal studies that followed women after they received their HIV diagnosis. [13][14][15][16] Women's decreased desire for additional children after learning they are HIVpositive has been explained by concerns over motherto-child transmission and leaving orphans, as well as by perceived health risks involved in pregnancy for an HIVpositive woman.…”

Contraceptive use in Adolescents with Perinatally and Behaviorally Acquired Human Immunodeficiency Virus Infection Seen in a Public Los Angeles County Clinic

“…HIV positive adolescent females are a unique population with compelling sexual and reproductive health needs. Their contraception practices have significant social ramifications in terms of risk of heterosexual transmission, re-infection and vertical transmission [3]. There are limited data that explore contraceptive choice and decision-making among these young women [4,5].…”