ICF Macro/MEASURE DHS, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA.
AIDS. 2009 Nov;23 Suppl 1:S7-S17. doi: 10.1097/01.aids.0000363773.83753.27.
HIV-positive women have particular needs for contraception to avoid unwanted pregnancy, to protect their own health and to eliminate the risk of transmitting HIV to an infant. In 2004, the United Nations described a four-element strategy to preventing mother-to-child transmission of HIV; the second element is preventing unintended pregnancies among HIV-positive women. However, fertility preferences among HIV-positive women who know their status remain poorly understood. This study seeks to demonstrate the degree to which knowledge of one's own serostatus is associated with fertility preferences and contraceptive demand and use.
This study uses Demographic and Health Surveys data and bivariate and multivariate methods to assess the contribution of a proxy variable for knowledge of own HIV serostatus to women's fertility desires, demand for contraception and contraceptive method choice for Zambia, Swaziland, Zimbabwe and Lesotho.
Knowledge of one's own HIV-positive serostatus is significantly associated with a desire to limit childbearing with contraceptive use, but not necessarily with unmet need for contraception. HIV-positive women who know their status are more likely than other women to use condoms.
HIV-positive women who know their serostatus exhibit fertility desires and contraceptive behaviors that are different from those of other women. These findings support the argument that efforts to scale up the second element of the strategy to prevent mother-to-child transmission of HIV should be accelerated: it is a cost-effective, rights-based approach to preventing incidence of mother-to-child transmission of HIV. Scaling up requires full commitment by both reproductive health/family planning and HIV constituencies to concerted integration at all levels of program planning, coordination and implementation.
HIV 阳性妇女对避孕有特殊需求，以避免意外怀孕，保护自身健康，并消除将 HIV 传染给婴儿的风险。2004 年，联合国提出了预防母婴传播 HIV 的四项策略；第二项策略是预防 HIV 阳性妇女的意外怀孕。然而，对于了解自身状况的 HIV 阳性妇女的生育意愿仍知之甚少。本研究旨在证明对自身血清状况的认识程度与生育意愿、避孕需求和使用之间的关联程度。
本研究使用人口与健康调查数据以及双变量和多变量方法，评估了解自身 HIV 血清状况的替代变量对赞比亚、斯威士兰、津巴布韦和莱索托妇女生育愿望、避孕需求和避孕方法选择的贡献。
了解自身 HIV 阳性血清状况与通过避孕来限制生育的愿望显著相关，但与避孕需求未得到满足并不一定相关。了解自身状况的 HIV 阳性妇女比其他妇女更有可能使用避孕套。
了解自身血清状况的 HIV 阳性妇女表现出的生育意愿和避孕行为与其他妇女不同。这些发现支持了这样一种观点，即应加快扩大预防母婴传播 HIV 战略第二项策略的力度：这是一种具有成本效益和基于权利的方法，可以预防母婴传播 HIV 的发生。扩大规模需要生殖健康/计划生育和 HIV 两个群体都充分承诺，在各级规划、协调和实施中进行协调整合。
