Sukeri Surianti, Sulaiman Zaharah, Hamid Noor Aman, Ibrahim Siti Aishah
School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Korean J Fam Med. 2024 Jan;45(1):27-36. doi: 10.4082/kjfm.23.0088. Epub 2023 Oct 18.
Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV).
A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.
Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.
The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.
马来西亚是西太平洋地区首个获得消除母婴传播人类免疫缺陷病毒（HIV）验证证书的国家。验证报告建议将感染HIV的妇女的性与生殖健康及权利作为优先事项。本文探讨并评估了马来西亚感染HIV的妇女（WLHIV）的性与生殖健康、权利以及获得医疗服务的情况。
对来自马来西亚各地的73名感染HIV的妇女进行了定性二次分析，包括11次深入访谈和16次焦点小组讨论。数据从原始访谈记录中提取，这些记录来自以下问题：（1）“作为一名感染HIV的女性，你在性与生殖健康及权利方面有哪些经历？”（2）“你在获取避孕措施方面有哪些经历？”（3）“作为一名感染HIV的女性，你日常生活中的经历是怎样的？”使用主题分析法对数据进行了分析。
研究结果出现了四个主题：“缺乏协商”“怀孕理想主义”“应对限制”和“过去与未来的恐惧”。这四个主题基于宗教、父权文化、母亲身份的意义和期望、冒险以及违背医疗建议以追求生育愿望、对HIV传播的恐惧以及避孕措施的副作用。
在避孕使用决策中涉及的复杂性揭示了感染HIV的妇女如何可能有未解决的生殖健康需求，这与医疗服务提供者对HIV管理和预防的关注不一致。针对改善马来西亚感染HIV的妇女的性与生殖健康及权利提出了建议，包括建立生殖健康咨询项目。
