Nguyen Lynn T, Minh Giang Le, Nguyen Diep B, Nguyen Trang T, Lin Chunqing
David Geffen School of Medicine, University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, USA.
Center for Training and Research On Substance Use and HIV, Hanoi Medical University, Room 211B, Building E3, No.1, Ton That Tung Street, Hanoi, Vietnam.
Reprod Health. 2024 Mar 11;21(1):34. doi: 10.1186/s12978-024-01768-3.
Human Immunodeficiency Virus (HIV) remains a significant public health concern worldwide. Women living with HIV/AIDS (WLHA) have the additional and unique need to seek sexual and reproductive health services. WLHA's maternal health journeys can be shaped by the cultural norms and resources that exist in their society. This study sought to understand if and how WLHA's family planning, pregnancy, and motherhood experiences could be influenced by the patriarchal culture, gender roles, and HIV stigma in Vietnam, specifically.
Between December 2021 and March 2022, 30 WLHA with diverse socioeconomic backgrounds and childbirth experiences were interviewed in Hanoi, Vietnam. These semi-structured interviews covered topics including HIV stigma, gender norms, pregnancy experiences, and child-rearing challenges. Interviews were audio recorded, transcribed, and analysed using ATLAS.ti.
Qualitative analyses of participant quotes revealed how limited information on one's health prospects and reproductive options posed a significant challenge to family planning. Societal and familial expectations as well as economic circumstances also influenced reproductive decision-making. WLHA often encountered substandard healthcare during pregnancy, labor, and delivery. Stigma and lack of provider attentiveness resulted in cases where women were denied pain relief and other medical services. Communication breakdowns resulted in failure to administer antiretroviral therapy for newborns. Motherhood for WLHA was shadowed by concerns for not only their own health, but also the wellbeing of their children, as HIV stigma affected their children at school and in society as well. Many WLHA highlighted the constructive or destructive role that family members could play in their childbirth decision-making and care-giving experiences.
Overall, this study underscores the complex ways that cultural expectations, family support, and stigma in healthcare impact WLHA. Efforts to educate and engage families and healthcare providers are warranted to better understand and address the needs of WLHA, ultimately improving their reproductive and maternal health.
人类免疫缺陷病毒（HIV）仍然是全球重大的公共卫生问题。感染艾滋病毒/艾滋病的妇女（WLHA）有额外且独特的需求来寻求性健康和生殖健康服务。WLHA的孕产经历会受到其所在社会的文化规范和资源的影响。本研究旨在具体了解越南的父权文化、性别角色和艾滋病毒污名化是否以及如何影响WLHA的计划生育、怀孕和为人母的经历。
2021年12月至2022年3月期间，在越南河内对30名具有不同社会经济背景和分娩经历的WLHA进行了访谈。这些半结构化访谈涵盖了包括艾滋病毒污名化、性别规范、怀孕经历和育儿挑战等主题。访谈进行了录音、转录，并使用ATLAS.ti进行分析。
对参与者引述的定性分析揭示了关于个人健康前景和生殖选择的信息有限如何给计划生育带来重大挑战。社会和家庭期望以及经济状况也影响了生殖决策。WLHA在怀孕、分娩和生产期间经常遇到不合格的医疗保健。污名化和医护人员缺乏关注导致妇女被拒绝给予止痛和其他医疗服务的情况。沟通不畅导致未能为新生儿提供抗逆转录病毒治疗。WLHA为人母不仅受到自身健康问题的困扰，还担心孩子的幸福，因为艾滋病毒污名化也影响到她们的孩子在学校和社会中的生活。许多WLHA强调了家庭成员在她们分娩决策和护理经历中可能发挥的建设性或破坏性作用。
总体而言，本研究强调了文化期望、家庭支持和医疗保健中的污名化对WLHA产生影响的复杂方式。有必要努力对家庭和医疗保健提供者进行教育并让他们参与进来，以更好地理解和满足WLHA的需求，最终改善她们的生殖健康和孕产妇健康。
