EXPLORING INTENTIONAL CHILDBEARING AND HIV RISK AMONG MEN & WOMEN WITH HIV/AIDS

探讨男性故意生育和艾滋病毒风险

• 批准号: 7229626
• 负责人: CARRIE E FOOTE
• 金额: $ 7.58万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-16 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7229626
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Address; American; Behavior; Behavioral; Bisexual; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Child; Child Welfare; Chronic; Clinic; Code; Collection; Conceptions; Condition; Couples; Data; Data Analyses; Decision Making; Depth; Diagnosis; Effectiveness; Epidemic; Ethics Committees; Family; Fertility; Fetus; Foundations; Frequencies; Fright; Future; HIV; Health; Health Personnel; Heterosexuals; Individual; Infection; Intervention; Interview; Joints; Knowledge; Lead; Left; Longevity; Measures; Medical; Medical Assistance; Motivation; Newborn Infant; Numbers; Orphan; Parents; Participant; Patient currently pregnant; Patients; Personal Satisfaction; Planned Pregnancy; Population; Pregnancy; Prevention program; Probability; Process; Provider; Psychiatric Social Work; Public Health; Rate; Reproductive Medicine; Reproductive Technology; Research; Risk; Risk-Taking; Sampling; Services; Sexual Partners; Societies; Techniques; Testing; Theoretical model; Tubal Ligation; United States National Institutes of Health; Vertical Disease Transmission; Virus; Virus Diseases; Woman; adopted child; antiretroviral therapy; behavior influence; child bearing; condoms; day; desire; disability; disease transmission; experience; improved; insight; men; prevent; psychologic; psychosocial; reproductive; social; theories; transmission process

DESCRIPTION (provided by applicant): As HIV infection is managed more as a chronic rather than fatal condition in the U.S., HIV-infected bisexual and heterosexual men and women increasingly acknowledge their intentions to have children. This poses challenging public health concerns. The attempt to have children may increase HIV transmission to sexual partners who do not use condoms when trying to conceive. Additionally, HIV infected women who become pregnant risk HIV transmission to the fetus. Although some HIV-infected men and women seek reproductive medical assistance to reduce HIV transmission risks to partners, these services remain largely inaccessible in the U.S.; furthermore, their HIV status may restrict them from adopting children. Despite these public health concerns, very little research has examined the reproductive decision making processes, psychosocial experiences surrounding intentional childbearing, and HIV sexual risk taking behaviors of HIV- infected men and women. The proposed research will obtain in-depth interview data from a sample of 40 HIV positive bisexual and heterosexual men and women who have, after HIV diagnosis, planned pregnancies (intentional childbearing), 20 of whom have achieved pregnancies and 20 of whom have been unsuccessful in achieving pregnancy. Participants will be privately interviewed to document their intentional childbearing experiences including the types of conception strategies used, frequency of use, what they know about HIV transmission, how they make decisions to have a child, whether they have engaged in unprotected intercourse to conceive a child, and how these experiences impact their day-to-day activities. The specific aims of this study are to: 1) Describe the psychosocial antecedents and experiences of intentional childbearing decisions among heterosexual and bisexual HIV-infected men and women, and to 2) Develop a theoretical model of how reproductive decision making processes influence the behavioral risk of horizontal HIV transmission. Data will be analyzed using grounded theory techniques, a process of joint collection, coding, and analysis of the data that allows for the basic social structural processes and meaning of a phenomenon to emerge. This project will generate preliminary data that can serve as the foundation for a R01 proposal to test the emergent theoretical model in a broader U.S. population of HIV-infected men and women. The study will also offer practical insights for HIV service and care providers of how HIV-infected men and women navigate the ethical and psychological strains around the decision to have children without harming the health of themselves or their partners and children. Finally, this study will help public health workers improve the effectiveness of HIV prevention programs by developing appropriate HIV interventions that take into account people's fertility motivations for engaging in HIV risk-taking behaviors.

描述(申请人提供)：由于艾滋病毒感染在美国更多地被视为一种慢性疾病，而不是致命的疾病，感染艾滋病毒的双性恋和异性恋男性和女性越来越多地承认他们想要孩子。这引发了对公共卫生的挑战。生孩子的尝试可能会增加艾滋病毒对试图怀孕时不使用避孕套的性伴侣的传播。此外，感染艾滋病毒的妇女怀孕后有可能将艾滋病毒传染给胎儿。尽管一些感染艾滋病毒的男性和女性寻求生殖医疗援助，以减少艾滋病毒传播给伴侣的风险，但这些服务在美国仍然很大程度上无法获得；此外，他们的艾滋病毒状况可能会限制他们收养孩子。尽管有这些公共卫生问题，但很少有研究研究艾滋病毒感染者的生殖决策过程、有意生育的心理社会经历以及艾滋病毒感染的性行为。拟议的研究将从40名艾滋病毒阳性双性恋和异性恋男女的样本中获得深入的访谈数据，这些人在艾滋病毒诊断后计划怀孕(有意生育)，其中20人已经怀孕，20人没有成功怀孕。参与者将接受私下采访，记录他们有意生育的经历，包括所使用的受孕策略的类型、使用频率、他们对艾滋病毒传播的了解、他们如何做出生孩子的决定、他们是否为了怀孕而进行无保护的性行为，以及这些经历如何影响他们的日常活动。这项研究的具体目的是：1)描述异性和双性恋HIV感染者中有意生育决定的心理社会先行因素和经验；2)建立生殖决策过程如何影响HIV水平传播行为风险的理论模型。数据分析将使用扎根的理论技术，这是一种联合收集、编码和分析数据的过程，允许出现一种现象的基本社会结构过程和意义。该项目将产生初步数据，作为R01提案的基础，该提案将在更广泛的美国艾滋病毒感染男性和女性人群中测试新出现的理论模型。这项研究还将为艾滋病毒服务和护理提供者提供实用的见解，了解艾滋病毒感染的男性和女性如何在不损害他们自己或他们的伴侣和孩子的健康的情况下，在决定要孩子的过程中克服伦理和心理压力。最后，这项研究将通过制定适当的艾滋病毒干预措施来帮助公共卫生工作者提高艾滋病毒预防计划的有效性，这些干预措施考虑到人们从事艾滋病毒风险行为的生育动机。