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Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study.

ABSTRACT: BACKGROUND: Antiretroviral therapy has created new expectations in the possibilities of procreation for persons living with HIV. Our objectives were to evaluate reproductive desire and to analyze the associated sociodemographic and clinical factors in HIV-infected women in the Spanish AIDS Research Network Cohort (CoRIS). METHODS: A mixed qualitative-quantitative approach was designed. Women of reproductive age (18-45) included in CoRIS were interviewed by phone, and data were collected between November 2010 and June 2012 using a specifically designed questionnaire. Reproductive desire was defined as having a desire to be pregnant at present or having unprotected sex with the purpose of having children or wanting to have children in the near future. RESULTS: Overall, 134 women were interviewed. Median age was 36 years (IQR 31-41), 55% were Spanish, and 35% were unemployed. 84% had been infected with HIV through unprotected sex, with a median time since diagnosis of 4.5 years (IQR 2.9-6.9). Reproductive desire was found in 49% of women and was associated with: 1) Age (women under 30 had higher reproductive desire than those aged 30-39; OR =?4.5, 95% CI 1.4-14.3); 2) having no children vs. already having children (OR =?3.2; 1.3-7.7 3); Being an immigrant (OR =?2.2; 1.0-5.0); and 4) Not receiving antiretroviral treatment (OR =?3.6; 1.1-12.1). The main reasons for wanting children were related to liking children and wanting to form a family. Reasons for not having children were HIV infection, older age and having children already. Half of the women had sought or received information about how to have a safe pregnancy, 87% had disclosed their serostatus to their family circle, and 39% reported having experienced discrimination due to HIV infection. CONCLUSIONS: The HIV-infected women interviewed in CoRIS have a high desire for children, and the factors associated with this desire are not fundamentally different from those of women in the general population. Maternity may even help them face a situation they still consider stigmatized and prefer not to disclose. Health-care protocols for handling HIV-positive women should incorporate specific interventions on sexual and reproductive health to help them fulfill their procreation desire and experience safe pregnancies.

SUBMITTER: Hernando V

PROVIDER: S-EPMC4063425 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study.

Hernando Victoria V Alejos Belén B Álvarez Débora D Montero Marta M Pérez-Elías M Jesús MJ Blanco Jose Ramón JR Masiá Mar M Del Romero Jorge J de los Santos Ignacio I Rio Isabel I Llácer Alicia A

BMC pregnancy and childbirth 20140605

<h4>Background</h4>Antiretroviral therapy has created new expectations in the possibilities of procreation for persons living with HIV. Our objectives were to evaluate reproductive desire and to analyze the associated sociodemographic and clinical factors in HIV-infected women in the Spanish AIDS Research Network Cohort (CoRIS).<h4>Methods</h4>A mixed qualitative-quantitative approach was designed. Women of reproductive age (18-45) included in CoRIS were interviewed by phone, and data were colle ...[more]

PMID: 24902487

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Project description:BackgroundThe fertility desire of women living with HIV to have children can have significant implications for public health. Despite the increase in the number of HIV-positive women, the issues of their fertility desire have not been well-studied. This study aims to assess fertility desire and associated factors among women living with HIV/AIDS.MethodsA facility-based cross-sectional study was conducted from 1 May to 30 July 2021. The researchers employed a systematic sampling technique. The data were gathered and entered into EpiData 3.1 software, and subsequently exported to the statistical package for social science version 25 for analysis. Binary logistic regression analyses were used to identify the factors involved, and a p-value of <0.05 at a 95% confidence level was deemed to be statistically significant.ResultThe findings of this study indicate that 47.8% of women expressed a desire to conceive. Various factors such as parents' pressure [adjusted odds ratio (AOR) = 4.41, 95% confidence interval (CI): 2.15-9.05], community pressure (AOR = 2.62, 95% CI: 1.30-5.26), being married (AOR = 0.25, 95% CI: 0.09-0.73), having only female offspring (AOR = 2.57, 95% CI: 1.12-5.90), and having HIV seropositive children (AOR = 2.45, 95% CI: 1.23-4.85) had statistically significant association with fertility desire.ConclusionThe study area exhibited a high level of fertility desire. Various factors can influence fertility desire, including parents' pressure, community pressure, being married, having only female offspring, and having children who are HIV seropositive. When developing interventions on sexual and reproductive health issues, it is imperative for policymakers and healthcare providers who are working in antiretroviral therapy clinics to take into account the effects of these factors on women living with HIV. When designing and implementing prevention of mother-to-child transmission services, it is important to consider the fertility desires of mothers who are living with HIV.

Project description:BackgroundPersons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for "universal access to sexual and reproductive health (SRH)", women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal.MethodsA mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed.ResultsAmong 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206-1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419-21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978-18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services.ConclusionsUtilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.

Project description:BackgroundReproductive coercion (RC) is a common form of violence against women. It can take several expressions aiming at limiting women's reproductive autonomy. Thus, the frequency and how reproductive coercion can be resisted must be investigated. There is limited research regarding RC in Latin America. Therefore, this study aimed to measure RC prevalence and associated factors and to explore the women experiences and coping strategies for RC.MethodsA convergent mixed-methods study with parallel sampling was conducted in Nicaragua. A quantitative phase was applied with 390 women 18-35 years old attending three main urban primary health care facilities. Lifetime and 12 months of exposure to RC behaviors including pregnancy promotion (PP) and contraceptive sabotage (CS) were assessed. Poisson regression with a robust variance estimator was used to obtain adjusted prevalence rate ratios and 95% Confidence Intervals (CIs). In addition, seven in-depth interviews were collected and analyzed using qualitative content analysis.ResultsEver RC prevalence was 17.4% (95% CI, 13.8-21.6) with similar proportions reporting ever experiencing PP (12.6%, 95% CI 9.4-16.3) or ever experiencing CS (11.8%, 95% CI 8.7-15.4). The prevalence of last twelve months RC was slightly lower (12.3%, 95% CI, 9.2-16.0) than above. Twelve months PP (7.4%, 95% CI 5.0-10.5) and CS (8.7%, 95% CI 6.1-12.0) were also similar. Women's higher education was a protective factor against ever and 12 months of exposure to any RC behaviors by a current or former partner. Informants described a broad spectrum of coping strategies during and after exposure to RC. However, these rarely succeeded in preventing unintended pregnancies or regaining women's long-term fertility autonomy.ConclusionsOur facility-based study showed that men's RC is a continuous phenomenon that can be enacted through explicit or subtle behaviors. Women in our study used different strategies to cope with RC but rarely succeeded in preventing unintended pregnancies or regaining their long-term fertility autonomy. Population-based studies are needed assess this phenomenon in a larger sample. The Nicaraguan health system should screen for RC and develop policies to protect women's reproductive autonomy.

Dataset Information

Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study.

Publications

Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study.

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