Sexuality and childbearing as it is experienced by women living with HIV in Sweden: a lifeworld phenomenological study

Abstract

The effectiveness of antiretroviral treatment has reduced sexual HIV transmission and mother-to-child-transmission. To optimally support women living with HIV, health care providers need deepened knowledge about HIV, sexuality and childbearing. The aim of this study was to describe the phenomenon sexuality and childbearing as experienced by women living with HIV in Sweden. Data were collected by phenomenon-oriented interviews with 18 HIV-positive women. A reflective lifeworld analysis based on phenomenological philosophy was conducted, describing the meaning structure of the phenomenon. The essence of the phenomenon is that perceptions about HIV and its contagiousness profoundly influence sexual habits and considerations in relation to pregnancy and childbearing. These perceptions are formed in combination with knowledge and interpretations about HIV by the women themselves and by their environments. The essence is further described by its constituents: Risk of transmission imposes demands on responsibility; The contagiousness of HIV limits sexuality and childbearing; Knowledge about HIV transmission provides confident choices and decisions; and To re-create sexuality and childbearing. Although HIV has a low risk of transmission if being well treated, our study shows that HIV-positive women feel more or less contagious, which influences sexuality and decision-making in relation to become pregnant and give birth.

Experience of pregnancy and maternity by adolescents/young people born infected with HIV

“…They do not know they were pregnant or start to think about this possibility only when some signs are evident, such as period delay and nausea. This suggests a possible lack of knowledge about their body and a weak awareness about the relationship between the exercise of sexuality and reproductive possibilities, corroborating the study with adult women in Sweden (12) . This experience of "surprise" or little critical perception about the possibility of being pregnant suggests not prior reflection in relation to about the decision to generate, or not, a new being, either through preventive conducts for contraception or even for the non-infection of the partners.…”

“…When pregnancy occurs without having been planned and without having been the object of action in the course of health care, it becomes more complex to legitimize it. Conceiving a child in the context of HIV seropositivity can be an emotionally difficult experience for women (12) . It has a special connotation in adolescence, since it is a phase of life in which personal identity of Experience of pregnancy and maternity by adolescents/young people born infected with HIV Silva CBS, Motta MGC, Bellenzani R.…”

“…A study in Thailand points out that, often, having a child appears as proof that the mother could have prevented her VT infection (18) . In this sense, the existence of antiretroviral therapy is the main argument of some women to justify making the decision to become pregnant and overcoming fear of VT viable, as identified in a study in Sweden (12) . Therefore, this technical advance assists in deconstructing the belief of not being able to be a mother, due to HIV, allowing motherhood to emerge in her conception, and that of health professionals, as a woman's right, regardless of the serological condition, as objectively should be.…”

Differences in HIV treatment experiences, perceptions, and behaviors by gender and sexual orientation in 25 middle-income and high-income countries: Findings from the 2019 Positive Perspectives Survey

“…Differential peaks in age-specific HIV diagnosis rates have been noted between European males and females: rates were highest in men aged 25-29 years, versus the 30-39 years group for women 24 . Being diagnosed with HIV during those 'prime' years in a woman's life may have profound implications socially, professionally, physically, sexually, and emotionally [26][27][28][29] . Many women living with HIV first learn about their HIV diagnosis during pregnancy, during which time treatment adherence may be particularly challenging 5 .…”

Study protocol: becoming and being a mother living with HIV - a multicentre longitudinal mixed methods study among pregnant women living with HIV, non-pregnant women living with HIV and pregnant women not living with HIV in a high-income setting (the 2B MOM study)

“…The annual number of children born to WLWH in both Denmark and Finland has increased from 10 in the year 2000 to 45 in 2014, with no evidence of perinatal transmission of HIV if the mother has been well-treated with cART 1 8 10. In Sweden, approximately 60 to 80 children are born to WLWH each year 17…”