Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda.
Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda.
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DOI：
10.1186/1471-2458-13-98
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发表时间：
2013-02-02
影响因子：
4.5
通讯作者：
Kamya MR
中科院分区：
文献类型：
--
作者：
Wanyenze RK;Wagner GJ;Tumwesigye NM;Nannyonga M;Wabwire-Mangen F;Kamya MR
有些艾滋病毒/艾滋病 (PLHIV) 感染者想要孩子，而另一些人则想要避孕；这就需要提供全面的服务来满足这两种需求。这项研究探讨了乌干达两家诊所的艾滋病毒感染者生育或不生育的决定以及避孕偏好。这是一项定性横断面研究。我们对性活跃的成年男性和女性以及青春期女孩和男孩进行了 17 次焦点小组讨论和 14 次深度访谈，并对提供者进行了 8 次关键知情人访谈。总共有 106 人参与了访谈；通过焦点小组讨论包括 84 名客户。在关键研究问题和目标的指导下，使用了定性潜在内容分析技术。在检查转录本之前开发了编码系统。代码被分为类别，然后进一步确定主题和子主题。在避孕偏好方面，客户的偏好多种多样；有些人不喜欢避孕套、药丸和注射剂，而另一些人则更喜欢这些方法。人们对并发症的担忧主要集中在药物和注射剂方面，而方法的成本是注射剂、植入剂和宫内节育器的主要问题。除了艾滋病毒血清不一致和健康状况不佳（被认为是暂时的）之外，是否要孩子的决定在很大程度上受到社会文化因素的影响。所有成年男性、女性和青少年都表示需要生育孩子，最好是多个孩子。那些已经有了孩子的人想要更多孩子的主要原因是：孩子的性别（想要生女孩和男孩，尤其是男孩）、对大家庭的渴望、来自家庭的压力以及寻找新伴侣。医疗服务提供者支持生孩子的决定，尤其是那些根本没有孩子的人，但一些客户提到了医疗服务提供者的负面经历以及那些想要孩子的人的信息差距。这些发现表明，需要扩大针对艾滋病毒感染者的计划生育服务，以提供更多的避孕选择和信息，并扩大对那些想要孩子的人的支持。
Some people living with HIV/AIDS (PLHIV) want to have children while others want to prevent pregnancies; this calls for comprehensive services to address both needs. This study explored decisions to have or not to have children and contraceptive preferences among PLHIV at two clinics in Uganda. This was a qualitative cross-sectional study. We conducted seventeen focus group discussions and 14 in-depth interviews with sexually active adult men and women and adolescent girls and boys, and eight key informant interviews with providers. Overall, 106 individuals participated in the interviews; including 84 clients through focus group discussions. Qualitative latent content analysis technique was used, guided by key study questions and objectives. A coding system was developed before the transcripts were examined. Codes were grouped into categories and then themes and subthemes further identified. In terms of contraceptive preferences, clients had a wide range of preferences; whereas some did not like condoms, pills and injectables, others preferred these methods. Fears of complications were raised mainly about pills and injectables while cost of the methods was a major issue for the injectables, implants and intrauterine devices. Other than HIV sero-discordance and ill health (which was cited as transient), the decision to have children or not was largely influenced by socio-cultural factors. All adult men, women and adolescents noted the need to have children, preferably more than one. The major reasons for wanting more children for those who already had some were; the sex of the children (wanting to have both girls and boys and especially boys), desire for large families, pressure from family, and getting new partners. Providers were supportive of the decision to have children, especially for those who did not have any child at all, but some clients cited negative experiences with providers and information gaps for those who wanted to have children. These findings show the need to expand family planning services for PLHIV to provide more contraceptive options and information as well as expand support for those who want to have children.
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