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“Throwing the Dice”: Pregnancy Decision‐Making Among HIV‐Positive Women in Four U.S. Cities
Author(s) -
Kirshenbaum Sheri B.,
Hirky A. Elizabeth,
Correale Jacqueline,
Goldstein Rise B.,
Johnson Mallory O.,
RotheramBorus Mary Jane,
Ehrhardt Anke A.
Publication year - 2004
Publication title -
perspectives on sexual and reproductive health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.818
H-Index - 93
eISSN - 1931-2393
pISSN - 1538-6341
DOI - 10.1363/3610604
Subject(s) - pregnancy , psychological intervention , medicine , family planning , context (archaeology) , fertility , qualitative research , demography , psychology , family medicine , population , environmental health , psychiatry , paleontology , social science , genetics , sociology , research methodology , biology
CONTEXT Although AIDS‐related deaths among U.S. women have decreased, the number of HIV‐positive women, especially of reproductive age, has increased. A better understanding of the interaction between HIV and family planning is needed, especially as antiretroviral medications allow HIV‐positive women to live longer, healthier lives. METHODS Qualitative methods were used to examine pregnancy decision‐making among 56 HIV‐positive women in four U.S. cities. Biomedical, individual and socio cultural themes were analyzed in groups of women, categorized by their pregnancy experiences and intentions. RESULTS Regardless of women's pregnancy experiences or intentions, reproductive decision‐making themes included the perceived risk of vertical transmission, which was often overestimated; beliefs about vertical transmission risk reduction strategies; desire for motherhood; stigma; religious values; attitudes of partners and health care providers; and the impact of the mother's health and longevity on the child. Most women who did not want children after their diagnosis cited vertical transmission risk as the reason, and most of these women already had children. Those who became pregnant or desired children after their diagnosis seemed more confident in the efficacy of risk reduction strategies and often did not already have children. CONCLUSIONS Future studies may help clarify the relationship between factors that influence pregnancy decision‐making among HIV‐positive women. HIV‐positive and at‐risk women of childbearing age may benefit from counseling interventions sensitive to factors that influence infected women's pregnancy decisions.