Reproductive decision making among HIV-infected women
Description
The purpose of this study is to describe characteristics of HIV-infected women who choose various reproductive decisions: (1) to become pregnant, (2) to get sterilized, and (3) to have an elective abortion subsequent to learning their HIV diagnosis. The medical records of 298 HIV-infected women who attended an HIV outpatient clinic were reviewed. A subset of this cohort, consisting of 104 HIV-infected women who presented at the clinic, were interviewed. They were recruited into the study based on whether or not they had ever had a subsequent pregnancy, then reclassified based on their subsequent sterilization status. The few cases of subsequent abortion are described The subjects interviewed were primarily African American and had not finished high school. The mean age at diagnosis was 25 years. Women who had a subsequent pregnancy were more likely to be younger, unmarried, diagnosed earlier in the epidemic, and have a recent history of non-IV drug use. Trends were noted for a history of pregnancy loss, subsequent sterilization, and current use of birth control. Among women who had a subsequent pregnancy, 12% had planned the pregnancy, over half had tried to prevent it, and a third had neither planned nor tried to prevent the pregnancy. Among women who never had a subsequent pregnancy, the majority had made a conscious decision not to become pregnant, mainly due to fears of transmitting HIV to a child Women who had a subsequent sterilization were more likely to have a partner who wanted no more children, to already have a live birth, and to be Baptist than women who were not subsequently sterilized. Sterilized women showed a trend toward believing that HIV infected women should get sterilized and that HIV-infected pregnant women should not have an abortion. The majority of women who became sterilized said their HIV diagnosis greatly affected their decision and cited reasons similar to those given by women who did not have a subsequent pregnancy Counseling of HIV-infected women should include frank discussions of her lifestyle, appropriate referrals for substance abuse treatment when needed, timely and accurate information about perinatal transmission, and permanency planning for her children. A nondirective approach that helps clients understand the meaning of various alternatives for her own life and that supports her decisions should be utilized