Harrington Elizabeth K, Newmann Sara J, Onono Maricianah, Schwartz Katie D, Bukusi Elizabeth A, Cohen Craig R, Grossman Daniel
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94612, USA.
Infect Dis Obstet Gynecol. 2012;2012:809682. doi: 10.1155/2012/809682. Epub 2012 Jul 12.
Despite increasing efforts to address the reproductive health needs of people living with HIV, a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. This study explores the fertility intentions and family planning (FP) preferences of Kenyan women accessing HIV treatment. We conducted 30 semistructured interviews and qualitatively analyzed the data with a grounded theory approach. Fears of premature death, financial hardship, and perinatal HIV transmission emerged as reasons for participants' desire to delay/cease childbearing. Participants strongly identified FP needs, yet two-thirds were using male condoms alone or no modern method of contraception. Women preferred the HIV clinic as the site of FP access for reasons of convenience, provider expertise, and a sense of belonging, though some had privacy concerns. Our findings support the acceptability of integrated FP and HIV services. Efforts to empower women living with HIV to prevent unintended pregnancies must expand access to contraceptive methods, provide confidential services, and take into account women's varied reproductive intentions.
尽管为满足艾滋病毒感染者的生殖健康需求付出了越来越多的努力，但撒哈拉以南非洲的艾滋病毒阳性女性对避孕措施的需求仍有很大未得到满足。本研究探讨了接受艾滋病毒治疗的肯尼亚女性的生育意愿和计划生育偏好。我们进行了30次半结构化访谈，并采用扎根理论方法对数据进行了定性分析。对过早死亡、经济困难和围产期艾滋病毒传播的恐惧成为参与者希望推迟/停止生育的原因。参与者强烈意识到计划生育的需求，但三分之二的人仅使用男用避孕套或未采用任何现代避孕方法。出于方便、提供者专业知识和归属感等原因，女性更倾向于在艾滋病毒诊所获取计划生育服务，不过有些人担心隐私问题。我们的研究结果支持将计划生育和艾滋病毒服务整合的可接受性。为增强感染艾滋病毒女性预防意外怀孕的能力所做的努力必须扩大避孕方法的获取途径，提供保密服务，并考虑到女性不同的生育意愿。
