Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Health care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa

Authors: Jennifer Moodley, Diane Cooper, Joanne E Mantell, Erin Stern

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

Within the health system, limited attention is given to supporting the fertility and parenting desires on HIV-positive people. In this study, we explore health care providers’ knowledge and perspectives on safer conception and alternate parenting strategies for HIV-positive people.

Methods

Between November 2007 and January 2008, in-depth interviews were conducted with 28 health care workers involved in providing HIV and/or antiretroviral services at public sector clinics in Cape Town, South Africa. Views on sexual and reproductive health services, pregnancy, childbearing and parenting in HIV-positive men and women were explored using a semi-structured interview guide. Data were analyzed using a thematic approach.

Results

Providers recognized the sexual and reproductive rights of HIV-positive individuals, but struggled with the tension between supporting these rights and concerns about spreading infection. Limited knowledge of safer conception methods constrained their ability to counsel and support clients in realizing fertility desires. Providers believed that parenting alternatives that do not maintain biological and cultural linkage are unlikely to be acceptable options.

Conclusions

Health care provider training and support is critical to providing comprehensive sexual and reproductive health care and meeting the fertility desires of HIV-positive people.
Literature
1.
Joint United Nations Programme on HIV/AIDS (UNAIDS): Global report: UNAIDS report on the global AIDS epidemic. 2013
2.
Mantell JE, Smit JA, Stein ZA: The right to choose parenthood among HIV-infected women and men. J Public Health Policy. 2009, 30 (4): 367-378. 10.1057/jphp.2009.35.CrossRefPubMedPubMedCentral
3.
Preston-whyte E: Culture, context and behaviour: anthropological perspectives on fertility in Southern Africa. South Afr J Demogr. 1988, 2 (1): 13-23.PubMed
4.
Laher F, Todd CS, Stibich MA, Phofa R, Behane X, Mohapi L, Gray G: A qualitative assessment of decisions affecting contraceptive utilization and fertility intentions among HIV-positive women in Soweto, South Africa. AIDS Behav. 2009, 13 (Suppl 1): 47-54.CrossRefPubMed
5.
Todd CS, Stibich MA, Laher F, Malta MS, Bastos FI, Imbuki K, Shaffer DN, Sinei SK, Gray GE: Influence of culture on contraceptive utilization among HIV-positive women in Brazil, Kenya, and South Africa. AIDS Behav. 2011, 15 (2): 454-468. 10.1007/s10461-010-9848-z.CrossRefPubMed
6.
Cooper D, Harries J, Myer L, Orner P, Bracken H, Zweigenthal V: “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med. 2007, 65 (2): 274-283. 10.1016/j.socscimed.2007.03.019.CrossRefPubMed
7.
Dyer SJ: The value of children in African countries: insights from studies on infertility. J Psychosom Obstet Gynaecol. 2007, 28 (2): 69-77. 10.1080/01674820701409959.CrossRefPubMed
8.
Dyer SJ, Abrahams N, Mokoena NE, Van der Spuy ZM: ‘You are a man because you have children’: experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa. Hum Reprod. 2004, 19 (4): 960-967. 10.1093/humrep/deh195.CrossRefPubMed
9.
Myer L, Morroni C, Rebe K: Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa. AIDS Patient Care STDS. 2007, 21 (4): 278-285. 10.1089/apc.2006.0108.CrossRefPubMed
10.
Nattabi B, Li J, Thompson SC, Orach CG, Earnest J: A systematic review of factors influencing fertility desires and intentions among people living with HIV/AIDS: implications for policy and service delivery. AIDS Behav. 2009, 13 (5): 949-968. 10.1007/s10461-009-9537-y.CrossRefPubMed
11.
Wanyenze RK, Wagner GJ, Tumwesigye NM, Nannyonga M, Wabwire-Mangen F, Kamya MR: Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda. BMC Public Health. 2013, 13: 98-2458. 10.1186/1471-2458-13-98. 13-98CrossRefPubMedPubMedCentral
12.
Da Silveira RA, Fonsechi-Carvasan GA, Makuch MY, Amaral E, Bahamondes L: Factors associated with reproductive options in HIV-infected women. Contraception. 2005, 71 (1): 45-50. 10.1016/j.contraception.2004.07.001.CrossRef
13.
Cooper D, Moodley J, Zweigenthal V, Bekker LG, Shah I, Myer L: 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 Behav. 2009, 13 (Suppl 1): 38-46.CrossRefPubMed
14.
Kaida A, Matthews LT, Kanters S, Kabakyenga J, Muzoora C, Mocello AR, Martin JN, Hunt P, Haberer J, Hogg RS, Bangsberg DR: Incidence and predictors of pregnancy among a cohort of HIV-positive women initiating antiretroviral therapy in Mbarara, Uganda. PLoS One. 2013, 8 (5): e63411-10.1371/journal.pone.0063411.CrossRefPubMedPubMedCentral
15.
Feldman R, Maposhere C: Safer sex and reproductive choice: findings from “positive women: voices and choices” in Zimbabwe. Reprod Health Matters. 2003, 11 (22): 162-173. 10.1016/S0968-8080(03)02284-5.CrossRefPubMed
16.
Harries J, Cooper D, Myer L, Bracken H, Zweigenthal V, Orner P: Policy maker and health care provider perspectives on reproductive decision-making amongst HIV-infected individuals in South Africa. BMC Public Health. 2007, 7: 282-10.1186/1471-2458-7-282.CrossRefPubMedPubMedCentral
17.
Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006, 3 (2): 77-101. 10.1191/1478088706qp063oa.CrossRef
18.
Steiner RJ, Finocchario-Kessler S, Dariotis JK: Engaging HIV care providers in conversations with their reproductive-age patients about fertility desires and intentions: a historical review of the HIV epidemic in the United States. Am J Public Health. 2013, 103 (8): 1357-1366. 10.2105/AJPH.2013.301265.CrossRefPubMedPubMedCentral
19.
Fakoya A, Lamba H, Mackie N, Nandwani R, Brown A, Bernard E, Gilling-Smith C, Lacey C, Sherr L, Claydon P, Wallage S, Gazzard B: British HIV Association, BASHH and FSRH guidelines for the management of the sexual and reproductive health of people living with HIV infection 2008. HIV Med. 2008, 9 (9): 681-720. 10.1111/j.1468-1293.2008.00634.x.CrossRefPubMed
20.
Bekker L, Black V, Myer L, Rees H, Cooper D, Mall S, Mnyami C, Conradie F, Mahabeer I, Gilbert L, Schwartz S: Guideline on safer conception in fertile HIV-infected individuals and couples. South Afr J HIV Med. 2011, 12 (2): 31-44.
21.
Fonn S, Xaba M, San Tint K, Conco D, Varkey S: Reproductive health services in South Africa: from rhetoric to implementation. Reprod Health Matters. 1998, 6 (11): 22-32. 10.1016/S0968-8080(98)90079-9.CrossRef
22.
Moodley J, Kawonga M, Bradley J, Hoffman M: Challenges in implementing a cervical screening program in South Africa. Cancer Detect Prev. 2006, 30 (4): 361-368. 10.1016/j.cdp.2006.07.005.CrossRefPubMed
23.
Harries J, Stinson K, Orner P: Health care providers’ attitudes towards termination of pregnancy: a qualitative study in South Africa. BMC Public Health. 2009, 9: 296-2458. 10.1186/1471-2458-9-296. 9-296CrossRefPubMedPubMedCentral
24.
Shelton JD: The provider perspective: human after all. Int Fam Plan Perspect. 2001, 27 (3): 152-153. 10.2307/2673838. +161CrossRef
25.
Myer L, Morroni C, El-Sadr WM: Reproductive decisions in HIV-infected individuals. Lancet. 2005, 366 (9487): 698-700. 10.1016/S0140-6736(05)67155-3.CrossRefPubMed
26.
Matthews LT, Crankshaw T, Giddy J, Kaida A, Psaros C, Ware NC, Smit JA, Bangsberg DR: Reproductive counseling by clinic healthcare workers in Durban, South Africa: perspectives from HIV-infected men and women reporting serodiscordant partners. Infect Dis Obstet Gynecol. 2012, 2012: 146348.CrossRefPubMedPubMedCentral
27.
McIntyre J: Mothers infected with HIV: reducing maternal death and disability during pregnancy. Br Med Bull. 2003, 67 (1): 127-135. 10.1093/bmb/ldg012.CrossRefPubMed
28.
Ahdieh L: Pregnancy and infection with human immunodeficiency virus. Clin Obstet Gynecol. 2001, 44 (2): 154-166. 10.1097/00003081-200106000-00006.CrossRefPubMed
29.
MacCarthy S, Laher F, Nduna M, Farlane L, Kaida A: Responding to her question: a review of the influence of pregnancy on HIV disease progression in the context of expanded access to HAART in sub-Saharan Africa. AIDS Behav. 2009, 13 (Suppl 1): 66-71.CrossRefPubMed
30.
Chadwick RJ, Mantell JE, Moodley J, Harries J, Zweigenthal V, Cooper D: Safer conception interventions for HIV-affected couples: implications for resource-constrained settings. Top Antivir Med. 2011, 19 (4): 148-155.PubMed
31.
32.
Venter F: HIV treatment in South Africa: the challenges of an increasingly successful antiretroviral programme. South African Health Review 2012/13. Edited by: Padarath A, English R. 2013, Durban: Health Systems Trust
33.
Day C, Gray A: Health and related indicators. South African Health Review 2012/13. Edited by: Padarath A, English R. 2013, Durban: Health Systems Trust
Metadata
Title
Health care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa
Authors
Jennifer Moodley
Diane Cooper
Joanne E Mantell
Erin Stern
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-384

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue

Research article

Organizational readiness for knowledge translation in chronic care: a Delphi study

Research article

Developing cartoons for long-term condition self-management information

Research article

Experiences of stigma among women living with HIV attending sexual and reproductive health services in Kenya: a qualitative study

Research article

Weight management in Canada: an environmental scan of health services for adults with obesity

Research article

Cervical cancer prevention in reproductive health services: knowledge, attitudes and practices of midwives in Côte d’Ivoire, West Africa

Research article

Does the practice of blood film microscopy for detection and quantification of malaria parasites in northwest Ethiopia fit the standard?