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'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda

BACKGROUND: As highly active antiretroviral therapy (ART) restores health, fertility and sexual activity among HIV-infected adults, understanding how ART influences reproductive desires and decisions could inform interventions to reduce sexual and vertical HIV transmission risk. METHODS: We performe...

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Autores principales: King, Rachel, Khana, Kenneth, Nakayiwa, Sylvia, Katuntu, David, Homsy, Jaco, Lindkvist, Pille, Johansson, Eva, Bunnell, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223906/
https://www.ncbi.nlm.nih.gov/pubmed/21726467
http://dx.doi.org/10.1186/1471-2458-11-530
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author King, Rachel
Khana, Kenneth
Nakayiwa, Sylvia
Katuntu, David
Homsy, Jaco
Lindkvist, Pille
Johansson, Eva
Bunnell, Rebecca
author_facet King, Rachel
Khana, Kenneth
Nakayiwa, Sylvia
Katuntu, David
Homsy, Jaco
Lindkvist, Pille
Johansson, Eva
Bunnell, Rebecca
author_sort King, Rachel
collection PubMed
description BACKGROUND: As highly active antiretroviral therapy (ART) restores health, fertility and sexual activity among HIV-infected adults, understanding how ART influences reproductive desires and decisions could inform interventions to reduce sexual and vertical HIV transmission risk. METHODS: We performed a qualitative sub-study among a Ugandan cohort of 1,000 adults on ART with four purposively selected categories of participants: pregnant, not pregnant, delivered, and aborted. In-depth interviews examined relationships between HIV, ART and pregnancy, desire for children, perceived risks and benefits of pregnancy, decision-making regarding reproduction and family planning (FP) among 29 women and 16 male partners. Analysis focused on dominant explanations for emerging themes across and within participant groups. RESULTS: Among those who had conceived, most couples stated that their pregnancy was unintentional, and often occurred because they believed that they were infertile due to HIV. Perceived reasons for women not getting pregnant included: ill health (included HIV infection and ART), having enough children, financial constraints, fear of mother-to-child HIV transmission or transmission to partner, death of a child, and health education. Most women reported FP experiences with condoms and hormonal injections only. Men had limited FP information apart from condoms. CONCLUSIONS: Counselling at ART initiation may not be sufficient to enable women who do not desire children to adopt relevant family planning practices. On-going reproductive health education and FP services, with emphasis on the restoration of fertility after ART initiation, should be integrated into ART programs for men and women.
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spelling pubmed-32239062011-11-26 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda King, Rachel Khana, Kenneth Nakayiwa, Sylvia Katuntu, David Homsy, Jaco Lindkvist, Pille Johansson, Eva Bunnell, Rebecca BMC Public Health Research Article BACKGROUND: As highly active antiretroviral therapy (ART) restores health, fertility and sexual activity among HIV-infected adults, understanding how ART influences reproductive desires and decisions could inform interventions to reduce sexual and vertical HIV transmission risk. METHODS: We performed a qualitative sub-study among a Ugandan cohort of 1,000 adults on ART with four purposively selected categories of participants: pregnant, not pregnant, delivered, and aborted. In-depth interviews examined relationships between HIV, ART and pregnancy, desire for children, perceived risks and benefits of pregnancy, decision-making regarding reproduction and family planning (FP) among 29 women and 16 male partners. Analysis focused on dominant explanations for emerging themes across and within participant groups. RESULTS: Among those who had conceived, most couples stated that their pregnancy was unintentional, and often occurred because they believed that they were infertile due to HIV. Perceived reasons for women not getting pregnant included: ill health (included HIV infection and ART), having enough children, financial constraints, fear of mother-to-child HIV transmission or transmission to partner, death of a child, and health education. Most women reported FP experiences with condoms and hormonal injections only. Men had limited FP information apart from condoms. CONCLUSIONS: Counselling at ART initiation may not be sufficient to enable women who do not desire children to adopt relevant family planning practices. On-going reproductive health education and FP services, with emphasis on the restoration of fertility after ART initiation, should be integrated into ART programs for men and women. BioMed Central 2011-07-05 /pmc/articles/PMC3223906/ /pubmed/21726467 http://dx.doi.org/10.1186/1471-2458-11-530 Text en Copyright ©2011 King et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
King, Rachel
Khana, Kenneth
Nakayiwa, Sylvia
Katuntu, David
Homsy, Jaco
Lindkvist, Pille
Johansson, Eva
Bunnell, Rebecca
'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title_full 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title_fullStr 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title_full_unstemmed 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title_short 'Pregnancy comes accidentally - like it did with me': reproductive decisions among women on ART and their partners in rural Uganda
title_sort 'pregnancy comes accidentally - like it did with me': reproductive decisions among women on art and their partners in rural uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223906/
https://www.ncbi.nlm.nih.gov/pubmed/21726467
http://dx.doi.org/10.1186/1471-2458-11-530
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