Date of Award

1-1-2010

Document Type

Campus Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Lucy Annang

Abstract

Black women of childbearing age residing in the Southeastern, US are disproportionately impacted by the HIV/AIDS epidemic. Considering the potential risks of transmitting the virus to an infant and/or uninfected sexual partner combined with concerns about the possibility of leaving a living child behind after a mother's death, one might expect HIV-positive women to either delay or completely avoid childbearing. Despite such unique challenges, research studies reveal that HIV-positive women's pregnancy desires differ very little from those of non-infected women. Hence, the overall goal of this research study was to understand factors which influence pregnancy intentions among HIV-positive women in South Carolina, with a particular focus on the impact of women's sexual partners on intentions. This study employed a qualitative, research design through which forty-two (N=42) self-identified, HIV-positive Black women of childbearing capacity were recruited from participating clinics to complete face-to-face in-depth interviews. Interviews were digitally recorded, transcribed, and later analyzed separately by two coders utilizing NVivo 8 software. Of the 42 respondents, 39 (92.8%) women expressed no intent to become pregnant, while three (7.1%) respondents indicated that they intended to become pregnant. Several recurrent themes emerged which highlight factors influencing the pregnancy intentions of HIV-positive women. These include: (1) concerns surrounding the potential to transmit the virus to the infant; (2) financial instability; (3) single relationship status; (4) age; and (5) previous childbearing and/or childrearing experience. Additionally, several themes emerged highlighting the influence of women's sexual partners. These include: (1) women's pregnancy intentions minimally influenced by the HIV serostatus of their sexual partners; (2) women's pregnancy intentions minimally influenced by their partner's desire to have children; (3) low HIV risk perceptions exhibited by sexual partners with a negative or unknown status; and (4) a lack of willingness among men in serodiscordant partnerships to explore alternative methods for conception. Study findings support the need to advocate for national policies and multilevel interventions which support women's reproductive autonomy in addition to focusing on reducing conception-and pregnancy-related transmission risks to infants and sexual partners. Findings also lend support for increasing the availability and accessibility of integrated HIV care and reproductive health services.

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