MacCarthy Sarah, Rasanathan Jennifer J K, Ferguson Laura, Gruskin Sofia
The Miriam Hospital and Alpert Medical School of Brown University, Providence, RI, USA.
Reprod Health Matters. 2012 Dec;20(39 Suppl):119-40. doi: 10.1016/S0968-8080(12)39641-9.
Despite the growing number of women living with and affected by HIV, there is still insufficient attention to their pregnancy-related needs, rights, decisions and desires in research, policy and programs. We carried out a review of the literature to ascertain the current state of knowledge and highlight areas requiring further attention. We found that contraceptive options for pregnancy prevention by HIV-positive women are insufficient: condoms are not always available or acceptable, and other options are limited by affordability, availability or efficacy. Further, coerced sterilization of women living with HIV is widely reported. Information gaps persist in relation to effectiveness, safety and best practices regarding assisted reproductive technologies. Attention to neonatal outcomes generally outweighs attention to the health of women before, during and after pregnancy. Access to safe abortion and post-abortion care services, which are critical to women's ability to fulfill their sexual and reproductive rights, are often curtailed. There is inadequate attention to HIV-positive sex workers, injecting drug users and adolescents. The many challenges that women living with HIV encounter in their interactions with sexual and reproductive health services shape their pregnancy decisions. It is critical that HIV-positive women be more involved in the design and implementation of research, policies and programs related to their pregnancy-related needs and rights.
尽管感染艾滋病毒并受其影响的女性人数不断增加，但在研究、政策和项目中，对她们与怀孕相关的需求、权利、决定和愿望仍未给予足够关注。我们对文献进行了综述，以确定当前的知识状况，并突出需要进一步关注的领域。我们发现，艾滋病毒呈阳性的女性用于预防怀孕的避孕选择不足：避孕套并非总是可得或可接受，其他选择则受到可负担性、可得性或有效性的限制。此外，广泛报道了对感染艾滋病毒女性的强制绝育情况。在辅助生殖技术的有效性、安全性和最佳做法方面，信息差距依然存在。对新生儿结局的关注通常超过对女性怀孕前、怀孕中和怀孕后健康的关注。获得安全堕胎和堕胎后护理服务对于女性实现其性权利和生殖权利至关重要，但这些服务往往受到限制。对艾滋病毒呈阳性的性工作者、注射吸毒者和青少年关注不足。感染艾滋病毒的女性在与性健康和生殖健康服务互动中遇到的诸多挑战影响了她们的怀孕决定。至关重要的是，艾滋病毒呈阳性的女性应更多地参与与其怀孕相关需求和权利有关的研究、政策和项目的设计与实施。
