Padmasri Yalamanchili, Varanasi Soumya
Department of Community Medicine, Government Medical College, Srikakulam, Andhra Pradesh, India.
Department of Community Medicine, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
J Family Med Prim Care. 2025 Jun;14(6):2374-2379. doi: 10.4103/jfmpc.jfmpc_1884_24. Epub 2025 Jun 30.
Pregnancies among HIV-positive women can lead to adverse maternal and child outcomes with added negative impact on the health system. This study intended to explore the correlates of unintended pregnancies among HIV-positive women.
After obtaining written informed consent, in-depth interviews (IDI) were conducted among HIV-positive women of 18-49 years age registered at the four anti-retroviral therapy (ART) centers of erstwhile Visakhapatnam district from 1 July 2020 to 30 June 2022 who were ever pregnant during this period by using a pre-validated interview guide. IDI were conducted until data saturation at each ART center. A focus group discussion was conducted with counsellors from integrated counselling and testing centers and members of Prevention of Mother To Child Transmission Advisory committee. The confidentiality of the participants was strictly maintained.
A total of 17 HIV-positive pregnant women were interviewed. Most women (13) knew their HIV status before becoming currently pregnant. Among these 13 women, nine were intentional pregnancies. The "patient perspective" included desire for children, challenges related to contraceptive usage, confidence that the use of ART prevents transmission to offspring, and financial reasons. Patient-related factors such as late reporting, availability of contraceptive services, and assurance given to ensure ART compliance were provider-related perspectives on pregnancies among HIV-positive women.
HIV positive couples either concordant or discordant, are confident of the effectiveness of the Anti retroviral treatment that they desire to have children like normal couples. Awareness and availability of dual contraception needs to be strengthened at ART centres.
HIV 阳性女性怀孕可能导致母婴不良结局，并对卫生系统产生额外的负面影响。本研究旨在探讨 HIV 阳性女性意外怀孕的相关因素。
在获得书面知情同意后，于 2020 年 7 月 1 日至 2022 年 6 月 30 日期间，对曾在原维沙卡帕特南地区四个抗逆转录病毒治疗（ART）中心登记的 18 - 49 岁 HIV 阳性孕妇进行深入访谈（IDI），这些孕妇在此期间曾怀孕，使用预先验证的访谈指南。在每个 ART 中心进行深入访谈直至数据饱和。与综合咨询和检测中心的咨询师以及预防母婴传播咨询委员会的成员进行了焦点小组讨论。严格保密参与者的信息。
共访谈了 17 名 HIV 阳性孕妇。大多数女性（13 名）在当前怀孕前就知道自己的 HIV 状况。在这 13 名女性中，9 例为有意怀孕。“患者视角”包括想要孩子、避孕使用相关挑战、对使用抗逆转录病毒疗法可防止传染给后代的信心以及经济原因。与患者相关的因素，如报告延迟、避孕服务的可及性以及为确保抗逆转录病毒疗法依从性所给予的保证，是医疗服务提供者对 HIV 阳性女性怀孕的相关观点。
HIV 阳性伴侣无论双方情况是否一致，都对抗逆转录病毒治疗的有效性充满信心，希望像正常夫妇一样生育子女。ART 中心需要加强对双重避孕的认知和可及性。
