Crankshaw Tamaryn L, Matthews Lynn T, Giddy Janet, Kaida Angela, Ware Norma C, Smit Jennifer A, Bangsberg David R
McCord Hospital, Durban, South Africa.
Reprod Health Matters. 2012 Dec;20(39 Suppl):50-60. doi: 10.1016/S0968-8080(12)39639-0.
Integrated reproductive health services for people living with HIV must address their fertility intentions. For HIV-serodiscordant couples who want to conceive, attempted conception confers a substantial risk of HIV transmission to the uninfected partner. Behavioral and pharmacologic strategies may reduce HIV transmission risk among HIV-serodiscordant couples who seek to conceive. In order to develop effective pharmaco-behavioral programs, it is important to understand and address the contexts surrounding reproductive decision-making; perceived periconception HIV transmission risk; and periconception risk behaviors. We present a conceptual framework to describe the dynamics involved in periconception HIV risk behaviors in a South African setting. We adapt the Information-Motivation-Behavioral Skill Model of HIV Preventative Behavior to address the structural, individual and couple-level determinants of safer conception behavior. The framework is intended to identify factors that influence periconception HIV risk behavior among serodiscordant couples, and therefore to guide design and implementation of integrated and effective HIV, reproductive health and family planning services that support reproductive decision-making.
为感染艾滋病毒的人群提供的综合生殖健康服务必须考虑到他们的生育意愿。对于想要怀孕的艾滋病毒血清学不一致的夫妇来说，尝试怀孕会使未感染的伴侣面临很大的艾滋病毒传播风险。行为和药物策略可能会降低寻求怀孕的艾滋病毒血清学不一致夫妇之间的艾滋病毒传播风险。为了制定有效的药物行为方案，了解并解决围绕生殖决策的背景、受孕前感知到的艾滋病毒传播风险以及受孕前的风险行为非常重要。我们提出一个概念框架，以描述南非背景下受孕前艾滋病毒风险行为所涉及的动态过程。我们调整了艾滋病毒预防行为的信息-动机-行为技能模型，以解决更安全受孕行为的结构、个人和夫妻层面的决定因素。该框架旨在识别影响血清学不一致夫妇受孕前艾滋病毒风险行为的因素，从而指导设计和实施支持生殖决策的综合有效的艾滋病毒、生殖健康和计划生育服务。
