HIV couples' anxiety and risk taking during ART

Leeuwen, Elisabeth van; Visser, Marja; Prins, Jan M.; Nieuwkerk, Pythia T.; Veen, Fulco van der

doi:10.1016/j.fertnstert.2007.06.086

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…5 No data are available to determine whether or not these pregnancies were planned. In 2009, a study undertaken in Zambia of 18 407 women at 16 ART clinics investigated contraceptive use, 10 and in 2008, a study undertaken in South Africa assessed dual contraception use (condoms plus additional contraception) in areas of high prevalence in South Africa. [12][13][14][15] These studies found that women with increased parity, women over 25 years of age and couples in short-term relationships, were more likely to use condoms than women with low levels of education and those in more stable or marital relationships.…”

Section: Introductionmentioning

confidence: 99%

Contraceptive knowledge and practice among HIV-positive women receiving antiretroviral therapy at a district hospital in KwaZulu-Natal

Somera

Ross

2013

South African Family Practice

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Objectives: To determine the knowledge and use of contraceptives by HIV-positive women attending an ART clinic.Design: Observational descriptive cross-sectional study.Setting and subjects: Many human immunodeficiency virus (HIV)-positive South African women fall pregnant each year while receiving antiretroviral therapy (ART). In 2010, 2 056 women of childbearing age attended the ART clinic at a district hospital south of Durban. Between October 2010 and June 2011, data were collected using a validated questionnaire from 400 women on their contraceptive knowledge and use. Women over 18 years of age who consented to participate, and who had been receiving ART for more than a month, were eligible for participation in the study.Outcome measures: Contraceptive knowledge and use.Results: All participants had received counselling on male condom use. The majority of HIV-positive women receiving ART preferred the male condom as their contraception of choice. Knowledge of male condoms was excellent, but only 66% of the study group used condoms, and just over 50% used a dual method of contraception (male condoms plus another contraceptive method). While 97% of participants were knowledgeable about injectable contraception, only 40% used the latter as a form of contraception. Ninety-two per cent of the participants reported recent sexual activity, 14% had fallen pregnant while receiving ART, and 64% planned on having a child in the future. Conclusion:The low use of dual contraception was a cause for concern. Recommendations include the integration of family planning services into HIV care at all ART sites. This should promote proper fertility management for women receiving ART.Peer reviewed.

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Section: Introductionmentioning

confidence: 99%

Contraceptive knowledge and practice among HIV-positive women receiving antiretroviral therapy at a district hospital in KwaZulu-Natal

Somera

Ross

2013

South African Family Practice

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“…La démarche en AMP même si elle implique beaucoup d'espoir, ne masque pas l'éventualité d'une aggravation de l'état de l'homme et la perspective pour la femme d'élever seule son enfant est envisagée [14]. Ces femmes expriment un très fort désir d'enfant, ainsi que leur conjoint [16], que l'on peut comparer à celui des couples infertiles. Le protocole d'AMP qui est proposé par la médecine est source d'anxiété [16] autant pour l'homme que pour la femme, car même si le risque de transmission est présenté comme réduit à presque zéro, la peur d'un passage du virus ne diminue pas pour autant.…”

Section: éTat De La Questionunclassified

“…Ces femmes expriment un très fort désir d'enfant, ainsi que leur conjoint [16], que l'on peut comparer à celui des couples infertiles. Le protocole d'AMP qui est proposé par la médecine est source d'anxiété [16] autant pour l'homme que pour la femme, car même si le risque de transmission est présenté comme réduit à presque zéro, la peur d'un passage du virus ne diminue pas pour autant. On constate que les risques que peuvent envisager de prendre les couples avant l'AMP sont plus liés à leur propre vécu affectif qu'aux explications données par les médecins.…”

Section: éTat De La Questionunclassified

“…On constate que les risques que peuvent envisager de prendre les couples avant l'AMP sont plus liés à leur propre vécu affectif qu'aux explications données par les médecins. Sur la base de données similaires, certains couples sont prêts à accepter l'éventualité d'un risque quasiment réduit, le désir d'enfant semblant prioritaire dans leur vie, alors que d'autres couples trouveront toujours trop élevé le risque le plus minime et demeureront anxieux même s'ils acceptent le traitement [16].…”

Section: éTat De La Questionunclassified

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Couples sérodifférents dont l’homme est infecté par le VIH et Assistance médicale à la procréation : le désir d’enfant et la grossesse aux prises avec la réalité de la maladie

Azemar¹,

Daudin²,

Bujan³

2010

Gynécologie Obstétrique & Fertilité

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“…While anxiety around transmission of HIV to partners and children does exist, there is evidence that the desire for pregnancy can outweigh these concerns [1]. The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals, including HIV-serodiscordant couples, therefore includes the need for interventions to support safe and healthy pregnancies, for those who desire children.…”

Section: Introductionmentioning

confidence: 99%

Achieving pregnancy safely for HIV‐serodiscordant couples: a social ecological approach

Saleem

Narasimhan

Denison

et al. 2017

Journal of the International AIDS Society

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The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.

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HIV couples' anxiety and risk taking during ART

Cited by 6 publications

References 18 publications

Contraceptive knowledge and practice among HIV-positive women receiving antiretroviral therapy at a district hospital in KwaZulu-Natal

Contraceptive knowledge and practice among HIV-positive women receiving antiretroviral therapy at a district hospital in KwaZulu-Natal

Couples sérodifférents dont l’homme est infecté par le VIH et Assistance médicale à la procréation : le désir d’enfant et la grossesse aux prises avec la réalité de la maladie

Achieving pregnancy safely for HIV‐serodiscordant couples: a social ecological approach

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