Mindry Deborah L, Milford Cecilia, Greener Letitia, Greener Ross M, Maharaj Pranitha, Letsoalo Thabo, Munthree Chantal, Crankshaw Tamaryn L, Smit Jennifer A
Center for Culture and Health, Semel Institute, University of California, Los Angeles, USA.
MatCH Research (Maternal, Adolescent and Child Health), Dept. of Obstetrics and Gynecology, Faculty of Health Sciences, University of Witwatersrand, Durban, South Africa.
Sex Reprod Healthc. 2016 Dec;10:35-40. doi: 10.1016/j.srhc.2016.03.005. Epub 2016 Mar 31.
OBJECTIVE(S): The childbearing needs of people living with HIV (PLHIV) and the experiences of healthcare providers serving them are explored. We examine provider and client knowledge and views on safer conception methods.
The study uses exploratory qualitative research to understand provider and client perspectives on childbearing and safer conception. Interviews were conducted at 3 sites (1 rural, 2 urban) in eThekwini District, KwaZulu-Natal, South Africa between May 2011 and August 2012, including in-depth interviews with 43 PLHIV, 2 focus group discussions and 12 in-depth interviews with providers.
Clients had little knowledge and providers had limited knowledge of safer conception methods. While clients were eager to receive counseling on safer conception, providers had some hesitations but were eager to receive training in delivering safer conception services. Clients and providers noted that biological parentage is a major concern of PLHIV. Clients were willing to use any of the described methods to have biological children but some expressed concerns about potential risks associated with timed unprotected intercourse. Male clients required access to reproductive health information.
Providers need to routinely initiate discussions with clients about childbearing intentions. Providers need to be enabled with approved guidelines and training to support client access to safer conception methods.
探讨感染艾滋病毒者（PLHIV）的生育需求以及为他们提供服务的医疗保健提供者的经历。我们研究了提供者和服务对象对更安全受孕方法的知识和看法。
本研究采用探索性定性研究方法，以了解提供者和服务对象对生育和更安全受孕的观点。2011年5月至2012年8月期间，在南非夸祖鲁-纳塔尔省伊泰夸尼区的3个地点（1个农村、2个城市）进行了访谈，包括对43名感染艾滋病毒者进行深入访谈、2次焦点小组讨论以及对提供者进行12次深入访谈。
服务对象对更安全受孕方法了解甚少，提供者的相关知识也有限。虽然服务对象渴望获得更安全受孕方面的咨询，但提供者有所犹豫，不过他们渴望接受提供更安全受孕服务方面的培训。服务对象和提供者指出，亲生父母身份是感染艾滋病毒者主要关心的问题。服务对象愿意使用任何所述方法生育亲生孩子，但一些人对定时无保护性交的潜在风险表示担忧。男性服务对象需要获取生殖健康信息。
提供者需要定期与服务对象就生育意愿展开讨论。需要为提供者提供经批准的指导方针和培训，以支持服务对象采用更安全的受孕方法。
