Biseck T, Kumwenda S, Kalulu K, Chidziwisano K, Kalumbi L
Department of Environmental Health, The Polytechnic, University of Malawi, Blantyre, Malawi.
School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Malawi Med J. 2015 Dec;27(4):128-34.
The proportions of women of reproductive age living with the human immunodeficiency virus (HIV) vary between different regions of the world, with significantly higher proportions in sub-Saharan Africa. Family planning is one of the major issues that couples and families affected with HIV must confront. We aimed to assess the cultural and social factors associated with childbearing and family planning knowledge, decision-making, and practices among HIV-positive pregnant women attending antenatal clinic at a health centre in Balaka, Malawi.
This was a qualitative descriptive study carried out at Kalembo Health Centre in Balaka. A purposive sampling technique was used to select pregnant women enroled in the antiretroviral therapy (ART) programme. A sample size of thirty-five women was decided upon after data saturation. Qualitative inquiry was used during data collection. Data were analysed using systematic text condensation, while numbers and percentages were generated using Microsoft Excel.
Out of 35 participants, 20 were aged between 25 and 34 years, and 18 had been married at least three times. All 35 women wished to have their own biological child. Factors, reported by participants, that promote childbearing included: the desire to please their husbands, fear of losing their husbands to others if they did not bear children, the knowledge that ART would help prevent their children from acquiring the virus, the desire to prove to others that they can also bear children, and a lack of family planning leading to unplanned pregnancies.
The factors that lead to pregnancies among women on ART in Balaka ranged from assured safety of the child from HIV, lack of contraception, to other factors related to their partners. The authors recognize and support the freedom for women to become pregnant and bear children, and, in the context of HIV infection, fertility and reproductive services should include a comprehensive approach towards addressing issues of HIV and AIDS and childbearing among infected women.
育龄期感染人类免疫缺陷病毒（HIV）的女性比例在世界不同地区有所不同，撒哈拉以南非洲地区的比例显著更高。计划生育是感染HIV的夫妇和家庭必须面对的主要问题之一。我们旨在评估马拉维巴拉卡一家健康中心产前诊所中HIV阳性孕妇在生育及计划生育知识、决策和实践方面的文化和社会因素。
这是一项在巴拉卡的卡伦博健康中心开展的定性描述性研究。采用目的抽样技术选取参加抗逆转录病毒疗法（ART）项目的孕妇。在数据饱和后确定了35名女性的样本量。数据收集过程中采用定性调查。使用系统文本浓缩法分析数据，同时使用Microsoft Excel生成数字和百分比。
在35名参与者中，20名年龄在25至34岁之间，18名至少结过三次婚。所有35名女性都希望拥有自己的亲生孩子。参与者报告的促进生育的因素包括：取悦丈夫的愿望、担心如果不生孩子丈夫会被别人抢走、知道抗逆转录病毒疗法有助于防止孩子感染病毒、向他人证明自己也能生孩子的愿望，以及缺乏计划生育导致意外怀孕。
巴拉卡接受抗逆转录病毒疗法的女性怀孕的因素包括孩子感染HIV有确定的安全性、缺乏避孕措施以及与伴侣相关的其他因素。作者认可并支持女性怀孕和生育的自由，并且在HIV感染的背景下，生育和生殖服务应包括全面解决HIV和艾滋病问题以及感染女性生育问题的方法。
