Women Living with HIV in South Africa and Their Concerns About Fertility

Health and quality of life benefits accrued from the availability of highly active antiretroviral therapy (HAART) are commendable, but the social milieu continues to pose challenges for women’s decision making around having children. This paper qualitatively explored women’s questions and concerns around living with HIV, being on HAART and pregnancy. Women of reproductive age were recruited from Eastern Cape and Gauteng Provinces, South Africa. Information on women’s fertility desires and pregnancy planning was collected through participatory workshop, focus groups, and one-on-one interviews. Three main themes emerged. Women living with HIV require information on the impact of HIV on pregnancy outcomes and vice versa. Women who are young, lost a child, not consistently using contraception or who have not been seriously ill have positive reproductive aspirations. Ambivalent attitudes of health care workers towards pregnancy impacts women’s fertility aspirations. Unbiased pre-conceptual communication should form part of HIV treatment and care services, despite expressed pregnancy intentions.