Investigating the role of stigma on fertility desire among HIV-positive women in Bangkok, Thailand: a qualitative study

OBJECTIVES: The Thai Ministry of Public Health is committed to reaching the United Nations’ goal of zero new HIV infections, zero AIDS-related deaths, and zero discrimination towards people living with HIV by 2030. While significant progress has been made towards the first two targets, stigma against women living with HIV (WLHIV), particularly in the context of their desire to have and raise children, remains an issue. METHODS: We conducted interviews with WLHIV (n=10) who expressed a desire to have a child or delivered an infant within 2 years of the study date, and key informants (KI) involved in their medical care and social support. We asked women about their HIV diagnosis, thoughts about pregnancy, desires to have children, and perceived stigma. KIs were asked about their perceptions of stigma towards WLHIV and policies or recommended actions to reduce discrimination towards this population. RESULTS: While the WLHIV reported that their healthcare providers had generally been supportive of them having children, internalised stigma and the perceived risk of or actual discrimination by community members negatively impacted fertility desire and peripartum experiences among the study participants. KIs confirmed similar sources of discrimination, emphasising more internalised and community-based stigma rather than from healthcare providers. Both groups highlighted the importance of increasing community education and awareness about HIV to reduce stigma. CONCLUSIONS: Complex issues around stigma and discrimination specific to women with HIV should be addressed at the community level in order to reach the goal of zero discrimination against all people living with HIV in Thailand.