Cooper Diane, Harries Jane, Myer Landon, Orner Phyllis, Bracken Hillary, Zweigenthal Virginia
University of Cape Town, Cape Town, South Africa.
Soc Sci Med. 2007 Jul;65(2):274-83. doi: 10.1016/j.socscimed.2007.03.019. Epub 2007 Apr 23.
This article reports on qualitative research investigating HIV positive individuals' reproductive intentions and their influencing factors in Cape Town, South Africa. In-depth interviews were held with 61 HIV positive women and men; at the time of interview, half had been receiving antiretroviral treatment (ART) for over 6 months and half were not receiving ART. Being HIV positive modified but did not remove reproductive desires, and diversity existed in reproductive intentions. Some HIV positive individuals wished to avoid pregnancy. Fears of partner and infant infection and having a previously infected baby were important factors deterring some individuals from considering having children. There was also strongly perceived community disapproval associated with HIV and reproduction. Strong desires to experience parenthood, mediated by prevailing social and cultural norms that encouraged childbearing in society more broadly, were reported by others. Motherhood was an important component of married women's identity and important for women's social status. Family, husbands' and societal expectations for childbearing were important influences on women's reproductive intentions, for some counterbalancing HIV as a factor discouraging reproduction. There was evidence that prevention of perinatal transmission programs in combination with ART may alter women and men's attitudes in favour of childbearing. Most HIV positive women had not discussed their reproductive desires and intentions with health care providers in HIV care or general health services because of anticipated negative reactions. The few who had done so perceived the counselling environment to be mostly unsupportive of open discussion on these issues. The findings highlight the need for explicit policies recognizing reproductive rights and choice. They support the need for health counselling and service interventions that advance safer and healthier reproductive options for HIV positive individuals in this region of the world which is experiencing a generalised and advanced HIV/AIDS pandemic.
本文报道了一项定性研究，该研究调查了南非开普敦艾滋病毒呈阳性个体的生育意愿及其影响因素。对61名艾滋病毒呈阳性的女性和男性进行了深入访谈；在访谈时，一半人接受抗逆转录病毒治疗（ART）已超过6个月，另一半未接受ART治疗。感染艾滋病毒改变了但并未消除生育欲望，生育意愿存在多样性。一些艾滋病毒呈阳性的个体希望避免怀孕。对伴侣和婴儿感染的恐惧以及曾有过感染艾滋病毒的婴儿是阻止一些人考虑生育的重要因素。人们还强烈感觉到社区对艾滋病毒与生育持反对态度。其他人报告说，在更广泛的社会中鼓励生育的主流社会和文化规范的影响下，他们有强烈的为人父母的愿望。母亲身份是已婚女性身份的重要组成部分，对女性的社会地位很重要。家庭、丈夫和社会对生育的期望对女性的生育意愿有重要影响，对一些人来说，这抵消了艾滋病毒作为阻碍生育的因素。有证据表明，预防围产期传播项目与抗逆转录病毒治疗相结合可能会改变男性和女性支持生育的态度。大多数艾滋病毒呈阳性的女性没有与艾滋病毒护理或一般医疗服务中的医疗保健提供者讨论过她们的生育欲望和意愿，因为预计会得到负面反应。少数这样做的人认为咨询环境大多不支持就这些问题进行公开讨论。研究结果强调需要制定明确承认生殖权利和选择的政策。它们支持开展健康咨询和服务干预的必要性，这些干预措施能为世界上这个正经历广泛和严重艾滋病毒/艾滋病流行的地区的艾滋病毒呈阳性个体提供更安全、更健康的生殖选择。
