A Qualitative Assessment of Decisions Affecting Contraceptive Utilization and Fertility Intentions among HIV-Positive Women in Soweto, South Africa

• DOI: 10.1007/s10461-009-9544-z
• Publication Date: 2009-03-23T18:24:11Z
• Authors: Fatima Laher; Catherine S. Todd; Mark A. Stibich; Rebecca Phofa; Xoliswa Behane; Lerato Mohapi; Glenda Gray
• Keywords: Adult; Decision Making; HIV Infections; Intention; Focus Groups; 3. Good health; Interviews as Topic; South Africa; 03 medical and health sciences; Fertility; 0302 clinical medicine; 5. Gender equality; Pregnancy; Antiretroviral Therapy, Highly Active; Humans; Women's Health; Female; Contraception Behavior; Qualitative Research

The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women.