Pregnancy decision-making among HIV positive women in Northern Vietnam: reconsidering reproductive choice

Bk, Chi; N., T.; Gammeltoft, Tine

doi:10.1080/13648470.2011.615909

Cited by 12 publications

(39 citation statements)

References 17 publications

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“…HIV status alone has been shown to neither predict nor influence a woman’s child bearing intentions [ 14 ]. Pregnancy decisions among HIV-positive women are influenced by family members, healthcare providers, and economic circumstances [ 15 ]. A qualitative study among HIV-positive Kenyan women found that childbearing carries an important cultural meaning that serves to solidify marriage [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants and Experiences of Repeat Pregnancy among HIV-Positive Kenyan Women—A Mixed-Methods Analysis

et al. 2015

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ObjectiveTo identify factors associated with repeat pregnancy subsequent to an index pregnancy among women living with HIV (WLWH) in western Kenya who were enrolled in a 24-month phase-II clinical trial of triple-ART prophylaxis for prevention of mother-to-child transmission, and to contextualize social and cultural influences on WLWH’s reproductive decision making.MethodsA mixed-methods approach was used to examine repeat pregnancy within a 24 month period after birth. Counselor-administered questionnaires were collected from 500 WLWH. Forty women (22 with a repeat pregnancy; 18 with no repeat pregnancy) were purposively selected for a qualitative interview (QI). Simple and multiple logistic regression analyses were performed for quantitative data. Thematic coding and saliency analysis were undertaken for qualitative data.ResultsEighty-eight (17.6%) women had a repeat pregnancy. Median maternal age was 23 years (range 15-43 years) and median gestational age at enrollment was 34 weeks. In multiple logistic regression analyses, living in the same compound with a husband (adjusted odds ratio (AOR): 2.33; 95% confidence interval (CI): 1.14, 4.75) was associated with increased odds of repeat pregnancy (p ≤ 0.05). Being in the 30-43 age group (AOR: 0.25; 95% CI: 0.07, 0.87), having talked to a partner about family planning (FP) use (AOR: 0.53; 95% CI: 0.29, 0.98), and prior usage of FP (AOR: 0.45; 95% CI: 0.25, 0.82) were associated with a decrease in odds of repeat pregnancy. QI findings centered on concerns about modern contraception methods (side effects and views that they ‘ruined the womb’) and a desire to have the right number of children. Religious leaders, family, and the broader community were viewed as reinforcing cultural expectations for married women to have children. Repeat pregnancy was commonly attributed to contraception failure or to lack of knowledge about post-delivery fertility.ConclusionsIn addition to cultural context, reproductive health programs for WLWH may need to address issues related to living circumstances and the possibility that reproductive-decision making may extend beyond the woman and her partner.

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Section: Introductionmentioning

confidence: 99%

Determinants and Experiences of Repeat Pregnancy among HIV-Positive Kenyan Women—A Mixed-Methods Analysis

et al. 2015

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“…Other studies have documented that economically dependent women are more likely to be influenced by family and partner preferences. (Bedimo, Bessinger, and Kissinger 1998; Kanniappan, Jeyapaul, and Kalyanwala 2008; Chi et al 2011; Lindgren et al 1998; Orner et al 2010; Orner et al 2011; Villela et al 2012; de Bruyn 2004, 2006)…”

Section: Discussionmentioning

confidence: 99%

Contemplating abortion: HIV-positive women's decision to terminate pregnancy

MacCarthy

Rasanathan

Crawford-Roberts

et al. 2014

Culture, Health & Sexuality

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Research on pregnancy termination (PT) largely assumes HIV status is the only reason why HIV-positive women contemplate abortion. As antiretroviral treatment (ART) becomes increasingly available and women are living longer, healthier lives, the time has come to consider the influence of other factors on HIV-positive women’s reproductive decision-making. Because ART has been free and universally available to Brazilians for more than two decades, Brazil provides a unique context in which to explore these issues. Twenty-five semi-structured interviews exploring women’s PT decision-making were conducted with women receiving care at the Reference Centre for HIV/AIDS in Salvador, Brazil. Interviews were transcribed, translated into English, and coded for analysis. HIV played different roles in women’s decision-making. 13 HIV-positive women did not consider PT. Influential factors described by those who did consider PT included fear of HIV transmission, fear of HIV-related stigma, family size, economic constraints, partner and provider influence, as well as lack of access to such services as PT and abortifacients. For some HIV-positive women in Brazil, HIV can be the only reason to consider PT, but other factors are significant. A thorough understanding of all variables affecting reproductive decision-making is necessary for enhancing services and policies and better meeting the needs and rights of HIV-positive women.

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“…Also, given the importance of the family (including in-laws) in reproductive health decisionmaking in Vietnam, 38,39 it is not surprising that many women in our study reported that family members advised abstinence and abortion. This advice may stem from the belief of family members that pregnancy will lead to further ill health in the woman and HIV infection in the child.…”

Section: Discussionmentioning

confidence: 99%

Women living with HIV in Vietnam: desire for children, use of sexual and reproductive health services, and advice from providers

Messersmith

Semrau

Anh

et al. 2012

Reproductive Health Matters

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In Vietnam, despite the possibility of living healthy sexual lives and bearing children due to the increasing availability of antiretroviral therapy and prevention of mother-to-child transmission services, HIV programming has given little attention to the sexual and reproductive health of people living with HIV. Our study explored factors influencing sexual and reproductive health decision-making, needs, rights and access to services for women living with HIV in Hai Phong and Ho Chi Minh City. Nearly half of the women were sexually active at the time of the study and 15% reported wanting a child or another child. Only 14% of women who did not want a child used contraceptive services in the last six months. More than 40% of women reported being advised, primarily by health care providers and family members, to abstain from sex, and more than 13% who were pregnant at the time of the study said that they had been advised to have an abortion. As with all women, women living with HIV must be informed of their sexual and reproductive rights and must have access to medically sound counseling and services to facilitate informed reproductive health decision-making. Sexual and reproductive health services are urgently needed for this population.

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Pregnancy decision-making among HIV positive women in Northern Vietnam: reconsidering reproductive choice

Cited by 12 publications

References 17 publications

Determinants and Experiences of Repeat Pregnancy among HIV-Positive Kenyan Women—A Mixed-Methods Analysis

Determinants and Experiences of Repeat Pregnancy among HIV-Positive Kenyan Women—A Mixed-Methods Analysis

Contemplating abortion: HIV-positive women's decision to terminate pregnancy

Women living with HIV in Vietnam: desire for children, use of sexual and reproductive health services, and advice from providers

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