Pintye Jillian, Ngure Kenneth, Curran Kathryn, Vusha Sophie, Mugo Nelly, Celum Connie, Baeten Jared M, Heffron Renee
1 Department of Global Health, University of Washington , Seattle, Washington.
2 Department of Nursing, University of Washington , Seattle, Washington.
AIDS Patient Care STDS. 2015 Sep;29(9):510-6. doi: 10.1089/apc.2015.0063.
HIV-serodiscordant couples often choose to attempt pregnancy despite their HIV transmission risk. Optimizing delivery of HIV risk reduction strategies during peri-conception periods (i.e., safer conception) requires understanding how HIV-serodiscordant couples approach fertility decisions. We conducted 36 in-depth individual interviews with male and female partners of Kenyan heterosexual HIV-serodiscordant couples who recently conceived. Transcripts were analyzed by gender and HIV serostatus using open coding. Matrices were used to identify patterns and emerging themes. Most participants expressed acceptance of being in an HIV-serodiscordant couple and affirmed their resilience to live with serodiscordance and achieve their fertility goals. Overall, while the goal for childbearing was unchanged, conception became an urgent desire so that both partners could experience childrearing together while the HIV-infected partner was still healthy. Children also add value to the relationship, and multiple children were a commonly expressed desire. Couples' desires dominated those of individual partners in fertility decision-making, but male preferences were more influential when the individual desires differed. Values and preferences of the couple as a unit may mediate fertility decision-making in HIV-discordant couples. Thus, it is important that safer conception programs include both partners when appropriate and consider the relationship context during risk reduction counseling and when recommending risk reduction interventions.
尽管存在艾滋病毒传播风险,但艾滋病毒血清学不一致的夫妇通常仍选择尝试怀孕。在受孕前后阶段优化艾滋病毒风险降低策略的实施(即更安全的受孕方式)需要了解艾滋病毒血清学不一致的夫妇如何做出生育决定。我们对肯尼亚异性恋艾滋病毒血清学不一致且近期怀孕的夫妇中的男性和女性伴侣进行了36次深入的个人访谈。通过开放式编码按性别和艾滋病毒血清状态对访谈记录进行了分析。使用矩阵来识别模式和新出现的主题。大多数参与者表示接受处于艾滋病毒血清学不一致的伴侣关系中,并肯定了他们应对血清学不一致并实现生育目标的能力。总体而言,虽然生育目标没有改变,但怀孕成为一种迫切愿望,这样双方伴侣都能在感染艾滋病毒的一方仍健康时共同体验养育子女的过程。孩子也为这种关系增添价值,生育多个孩子是普遍表达的愿望。在生育决策中,夫妇的愿望主导着个人伴侣的愿望,但当个人愿望不同时,男性的偏好更具影响力。作为一个整体的夫妇的价值观和偏好可能会影响艾滋病毒血清学不一致夫妇的生育决策。因此,重要的是,更安全的受孕计划在适当的时候应将双方伴侣都纳入其中,并在风险降低咨询以及推荐风险降低干预措施时考虑关系背景。