Safer Conception for Couples Affected by HIV: Structural and Cultural Considerations in the Delivery of Safer Conception Care in Uganda

In countries with high HIV prevalence and high fertility desires, the rights of HIV-affected couples to have children are a pressing issue. Conception among people living with HIV carries risks for both horizontal and vertical HIV transmission. In Uganda ~100,000 HIV-infected women become pregnant a...

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Bibliographic Details
Published in:AIDS and behavior 2017-08, Vol.21 (8), p.2488-2496
Main Authors: Mindry, Deborah, Wanyenze, Rhoda K., Beyeza-Kashesya, Jolly, Woldetsadik, Mahlet A., Finocchario-Kessler, Sarah, Goggin, Kathy, Wagner, Glenn
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Bias
Childbirth & labor
Children
Couples
Decision Making
Decisions
Delivery of Health Care
Disease transmission
Family planning
Female
Fertility
Fertilization
Gender Identity
Gender relations
Gender roles
Health care
Health Psychology
Health risks
Health services
HIV
HIV Infections - prevention & control
Human immunodeficiency virus
Humans
Infectious Disease Transmission, Vertical - prevention & control
Infectious Diseases
Interpersonal Relations
Male
Medicine
Medicine & Public Health
Men
Middle Aged
Norms
Original Paper
Pregnancy
Public Health
Qualitative Research
Reproduction
Reproductive Behavior
Reproductive health
Rights
Sexual Behavior
Sexual Partners
Social Norms
Social Stigma
Stigma
Uganda
Young Adult
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Summary:In countries with high HIV prevalence and high fertility desires, the rights of HIV-affected couples to have children are a pressing issue. Conception among people living with HIV carries risks for both horizontal and vertical HIV transmission. In Uganda ~100,000 HIV-infected women become pregnant annually. Providers face a number of challenges to preventing HIV transmission, reducing unplanned pregnancies, and ensuring safer conception. We report findings from interviews with 27 HIV-affected couples (54 individuals) in Uganda. We explored key cultural and structural factors shaping couples’ childbearing decisions. Our data reveal a complex intersection of gender norms, familial expectations, relationship dynamics, and HIV stigma influencing their decisions. Participants provided insights regarding provider bias, stigma, and the gendering of reproductive healthcare. To reduce horizontal transmission HIV and family planning clinics must address men’s and women’s concerns regarding childbearing with specific attention to cultural and structural challenges.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-017-1816-4