Pre-Conception
Gaps in Research
- 1.
- Women and their sexual partners need access to comprehensive pre- conception care so they can make informed decisions about pregnancy before conception.
- 2.
- Interventions are needed to support the autonomous decision-making of HIV-positive women who are caught between the contradictory pressures of family, community and health care providers.
- 3.
- Some HIV-positive men and women would consider adoption.
- 4.
- Women and their sexual partners need to know and understand how seroconversion can occur during pregnancy.
1. Women and their sexual partners need access to comprehensive pre- conception care so they can make informed decisions about pregnancy before conception. Studies found that HIV-positive women could not access pre- conception advice on safer pregnancy options, as health providers discouraged pregnancy. Studies found that significant numbers of pregnant women did not know any way to prevent vertical transmission.
Gap noted, for example, in South Africa (London et al., 2008); China (Luo and He, 2008); globally (Hirsch, 2007; Delvaux & Nöstlinger, 2007).
London, L., P. Orner and L. Myer. 2008. “’Even if You are Positive, You Still Have Rights Because You Are a Person’: Human Rights and the Reproductive Choice of HIV-positive Persons.” Developing World Bioethics 8 (1): 11-22.
2. Interventions are needed to support the autonomous decision-making of HIV-positive women who are caught between the contradictory pressures of family, community and health care providers. Studies found that HIV-positive women and men need information and social support to make decisions that reflect their own preferences in the face of pressure to bear children. A review of the published literature from 1990 to 2008 found that the refusal of health workers to discuss reproductive options in a non-biased way negatively impacts HIV-positive women. Studies also found that HIV-positive men lacked information on preconception and felt they could not request this information from health providers.
Gap noted, for example, in Vietnam (Oosterjoff et al., 2008), Brazil (Paiva et al., 2003), and South Africa (Nduna and Farlane, 2009).
Oosterjoff, P., N. Thu Anh, G. Thuy Hanh, P. Ngoc Yen, P. Wright and A. Hardon. 2008. “Holding the Line: Family Response to Pregnancy and the Desire for a Child in the Context of HIV in Vietnam.” Culture, Health and Sexuality 10(4): 403-416.
3. Some HIV-positive men and women would consider adoption. A study found that HIV-positive men and women would consider adopting a child as an alternative to having a biological child.
Gap noted, for example, in South Africa.
Cooper, D., J. Moodley, V. Zeigenthal, L. Bekker, I. Shah and L. Myer. 2009. “Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services.” AIDS Behavior 13: S38-S46.