The online version of this article (https://doi.org/10.1186/s12905-017-0483-y) contains supplementary material, which is available to authorized users.
Improved antiretroviral treatments and decrease in vertical transmission of HIV have led to a higher number of women living with HIV to consider childbearing. However, stigma and social rejection result in specific challenges that HIV positive women with procreation intentions have to face with. Our objective was to in depth analyse elements shaping their desire for procreation and specifically investigate the impact of HIV.
A qualitative study was conducted through open interviews with 20 women living with HIV between 18 and 45 years of age, from the Spanish AIDS Research Network Cohort (CoRIS). Interviews were audio-recorded and transcribed. A content analysis was performed.
HIV diagnosis is a turning point in women’s sexual and emotional life that is experienced traumatically. HIV diagnosis is usually associated with the fear of an immediate death and the idea of social isolation. At this moment, women temporarily reject future motherhood or having a sexual life. HIV status is only disclosed to the closed social circle and partner support is essential in HIV diagnosis assimilation process. Health professionals provide information on assisted reproductive technology and on how to minimize risk of partner HIV transmission. Most of barriers for procreation acknowledged by women are not related to HIV. However, women fear vertical transmission and experience other barriers derived from HIV infection. In this context, pregnancy makes women feel themselves as “normal women” despite HIV. Motherhood is considered an element of compensation that helps them to cope with HIV diagnosis. All these elements make health professionals key actors: they provide information and support after HIV diagnosis.
Barriers and drivers for procreation are similar among HIV positive women and general population. However, stigma and discrimination linked with HIV weigh in HIV positive women decision of motherhood. In this context, it is necessary to provide these women with the necessary counselling, guidance and resources to take decisions about procreation properly informed.
Additional file 1: “Interview script”. Interview script used to develop the interviews. In the Additional file 1 we included both, the original Spanish version and the English translation of the script. (DOCX 20 kb)
Sistema de Información sobre nuevos diagnósticos de VIH. [Epidemiological HIV/AIDS surveillance in Spain. Update June 30, 2017]. 2017. https://www.msssi.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/vigilancia/InformeVIH_SIDA_2017_NOV2017.pdf. Accessed 22 Jan 2018.
European Centre for Disease Prevention and Control. HIV/AIDS surveillance in Europe. 2016. Surveillance report. 2017. https://ecdc.europa.eu/sites/portal/files/documents/20171127-Annual_HIV_Report_Cover%2BInner.pdf. Accessed 22 Jan 2018.
Hernando V, Alejos B, Montero M, Perez-Elias M, Blanco JR, Giner L, et al. Reproductive history before and after HIV diagnosis: a cross-sectional study in HIV-positive women in Spain. Medicine. 2017;96:1–7. CrossRef
Chen JL, Philips KA, Kanouse DE, Collins RL, Miu A. Fertility desires and intentions of HIV-positive men and women. Fam Plan Perspect. 2001;33:144–52. 165 CrossRef
Fiore S, Heard I, Thorne C, Savasi V, Coll O, Malyuta R et al.: Reproductive experience of HIV-infected women living in Europe. Hum Reprod 2008, 23 : 2140-2144.
Panozzo L, Battegay M, Friedl A, Vernazza PL. High risk behaviour and fertility desires among heterosexual HIV-positive patients with a serodiscordant partner--two challenging issues. Swiss Med Wkly. 2003;133:124–7. PubMed
World Health Organization. Sexual and reproductive health of women living with HIV/AIDS. http://www.who.int/hiv/pub/guidelines/sexualreproductivehealth.pdf?ua=1. 2006. 7–1-2017.
Umea University. Open Code 3.06. 2013. http://www.phmed.umu.se/english/units/epidemiology/research/open-code/. Accessed 22 Jan 2018.
Centro de Investigaciones Sociológicas. [Survey “Fertility and Values in the Spanish society of the XXI century”]. http://www.cis.es/cis/export/sites/default/-Archivos/Marginales/2620_2639/2639/ES2639_13.pdf. 2006. 5–1-2017.
Centro de Investigaciones Sociológicas. [Survey on attitudes and opinions of women on the children and parenting]. http://www.cis.es/cis/export/sites/default/-Archivos/Marginales/2540_2559/2552/Es2552mar.pdf. 2003. 5–1-2017.
Cliffe S, Townsend CL, Cortina-Borja M, Newell ML. Fertility intentions of HIV-infected women in the United Kingdom. AIDS Care. 2011;24:1093–101. CrossRef
Ministerio de Sanidad SSeI. [National Commission on Assisted Human Reproduction. Regulations]. http://www.cnrha.msssi.gob.es/normativa/home.htm. 2014. 15–1-2017.
Ministerio de Sanidad SSeI. [Registry of Assisted Reproduction Centres]. www.cnrha.msssi.gob.es/registros/centros/home.htm. 2015. 15–1-2017.
Siegel K, Schrimshaw EW. Reasons and justifications for considering pregnancy among women living with HIV/AIDS. Psychol Women Q. 2001;25:112–23. CrossRef
- Role of HIV in the desire of procreation and motherhood in women living with HIV in Spain: a qualitative approach
Debora Alvarez-del Arco
Mª. Jesús Pérez-Elías
Jose Ramón Blanco
Jorge del Romero
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
e.Med Kampagnen-Visual, Mail Icon II