Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya.
Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya.
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DOI：
10.1080/09540121.2014.946385
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发表时间：
2015
期刊：
影响因子：
1.7
通讯作者：
Cohen CR
中科院分区：
文献类型：
--
作者：
Mmeje O;van der Poel S;Workneh M;Njoroge B;Bukusi E;Cohen CR
在女性HIV血清阳性的夫妇渴望孩子，家庭定时阴道授精的精液在生育期沿着一贯使用避孕套可能会减少艾滋病毒传播的风险时，该名男子是HIV未感染。在撒哈拉以南非洲，高达45%的艾滋病毒感染妇女希望生育更多子女。在资源匮乏的国家，艾滋病毒病毒载量评估并不经常用于监测抗逆转录病毒疗法的坚持和反应。因此，在这些情况下，没有HIV病毒抑制保证的定时无保护性交可能会造成不必要的风险。定时阴道人工授精是一种简单和负担得起的干预措施，可以被视为一种辅助方法和选择，通过治疗感染艾滋病毒的伴侣和/或暴露前预防，更安全地预防艾滋病毒。我们进行了5个混合和单一性别的焦点小组讨论，包括33艾滋病毒血清不一致的夫妇和医疗保健提供者在肯尼亚的尼扬扎地区，以评估可接受性和可行性定时阴道授精作为一种更安全的受孕方法。转录的数据进行了分析，使用扎根理论的方法。我们发现，教育和咨询艾滋病毒血清不一致的夫妇定时阴道授精可以使其成为一个可接受的和可行的更安全的概念方法时，与频繁的沟通和家访的医疗保健提供者。这项研究的结果表明，实施研究，整合培训和咨询的艾滋病毒血清不一致的夫妇和医疗保健提供者定时阴道授精结合一致的避孕套使用是必要的。承认和支持艾滋病毒血清反应呈阳性、阴性、但有生育愿望的夫妇的生殖选择和需要，还应包括使用辅助生殖服务，同时作为预防艾滋病毒性传播的药物选择。
In female-positive HIV-serodiscordant couples desiring children, home timed vaginal insemination of semen during the fertile period along with consistent condom use may reduce the risk of HIV transmission when the man is HIV-uninfected. In sub-Saharan Africa, up to 45% of HIV-infected women desire to have more children. HIV viral load assessment is not routinely available in low-resource countries for monitoring adherence and response to antiretroviral therapy. Therefore, in these settings, timed unprotected intercourse without assurance of HIV viral suppression may pose unnecessary risks. Timed vaginal insemination, a simple and affordable intervention, can be considered an adjunct method and option of safer conception for HIV prevention with treatment of the HIV-infected partner and/or pre-exposure prophylaxis. We conducted five mixed and single sex focus group discussions comprised of 33 HIV-serodiscordant couples and healthcare providers in the Nyanza region of Kenya to assess the acceptability and feasibility of timed vaginal insemination as a safer method of conception. The transcribed data was analyzed using a grounded theory approach. We found that educating and counseling HIV-serodiscordant couples on timed vaginal insemination could make it an acceptable and feasible safer conception method when associated with frequent communication and home visits by healthcare providers. The findings of this study indicate that implementation studies that integrate training and counseling of HIV-serodiscordant couples and healthcare providers on timed vaginal insemination combined with consistent condom use are needed. Acknowledging and supporting the reproductive choice and needs of female positive, male negative HIV-serodiscordant couples who desire children should also include the use of assisted reproductive services at the same time as pharmaceutical options that prevent sexual HIV transmission.