scholarly journals Predictors of Safer Conception Practices Among HIV-Infected Women in Northern Nigeria

2019 ◽  
Vol 8 (8) ◽  
pp. 480-487
Author(s):  
Zubairu Iliyasu ◽  
Hadiza S. Galadanci ◽  
Alfa I. Oladimeji ◽  
Musa Babashani ◽  
Auwalu U. Gajida ◽  
...  
Keyword(s):  
Risk Perception ◽  
Contraceptive Use ◽  
Intrauterine Insemination ◽  
Transmission Risk ◽  
Safer Conception ◽  
Fertility Desires ◽  
Persons Living With Hiv ◽  
Safer Conception Methods ◽  
Timed Unprotected Intercourse ◽  
Exposure Prophylaxis

Background: Persons living with HIV often face discrimination in safe sex and reproductive choices, especially in lowresource settings. This study assessed fertility desires and intentions, risk perception and correlates of ever use of at least one safer conception method among HIV-infected women attending a tertiary health facility in Kano, Nigeria. Methods: Structured questionnaires were administered to a cross section of 328 of 427 eligible HIV-infected women. Fertility desires and intentions, risk perception and safer conception practice were analyzed. Logistic regression was employed to assess for predictors. Results: Of the 328 respondents, 150 respondents (45.7%) wanted more children. The proportions of respondents aware of their transmission risk during pregnancy, delivery, and breastfeeding were 69.5%, 75.3%, and 78.9%, respectively. Further, 68.9% of respondents were aware of the prospects of bearing HIV-negative children without infecting their partners. About 64.8% of women were aware of at least one safer conception method. Safer conception methods everused by the participants include: antiretroviral therapy (ART) (36.7%), timed unprotected intercourse with (10.9%), and without pre-exposure prophylaxis (PrEP) (17.2%), intravaginal insemination (7.3%) and intrauterine insemination (4.7%). Safer conception practice was predicted by marital status (married versus single, adjusted odds ratio [AOR]=1.50, 95% CI =1.10-3.55), parity (2-4 versus 0, AOR=12.1, 95% CI=3.7-39.8), occupation (civil servants versus traders, AOR=0.37, 95% CI=0.16-0.86), husband’s serostatus (seroconcordant versus serodiscordant) (AOR=1.51, 95% CI=1.13-4.64), couple contraceptive use (users versus non-users) (AOR=1.62, 95% CI=1.16-5.83) and transmission risk perception (high risk versus low/no risk) (AOR=2.14, 95% CI=1.18-3.90). Conclusion: We found high levels of fertility desires and intentions and moderate risk perception among a cohort of HIV-infected women in urban Kano, Nigeria. The use of safer conception practices was not common. Our findings underscore the need for healthcare provider capacity building to enhance safer conception counseling and service delivery.

scholarly journals Health workers’ knowledge of safer conception and attitudes toward reproductive rights of HIV-infected couples in Kano, Nigeria

2019 ◽  
Vol 11 (6) ◽  
pp. 536-544
Author(s):  
Zubairu Iliyasu ◽  
Hadiza S Galadanci ◽  
Ahmad A Zubairu ◽  
Taiwo G Amole ◽  
Nadia A Sam-Agudu ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Health Workers ◽  
Reproductive Rights ◽  
Intrauterine Insemination ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Safer Conception ◽  
Vitro Fertilization ◽  
Safer Conception Methods

Abstract Background The restriction of reproductive rights of HIV-positive couples in low-resource settings could be related to the attitudes and skills of health workers. We assessed health workers’ knowledge of safer conception and their attitudes toward the reproductive rights of HIV-positive couples in a tertiary hospital in Nigeria. Methods A cross-section of health workers (n=294) was interviewed using structured questionnaires. Knowledge and attitude scores were analyzed. Logistic regression was employed to generate adjusted odds ratios (AORs) for predictors of attitude. Results Safer conception methods mentioned by respondents included timed unprotected intercourse with (27.9%) and without antiretroviral pre-exposure prophylaxis (37.4%), in vitro fertilization plus intracytoplasmic sperm injection (26.5%), and sperm washing and intrauterine insemination (24.8%). The majority (94.2%) of health workers acknowledged the reproductive rights of HIV-infected persons, although (64.6%) strongly felt that HIV-infected couples should have fewer children. Health workers reported always/nearly always counseling their patients on HIV transmission risks (64.1%) and safer conception (59.2% and 48.3% for females and males, respectively) (p<0.05). Among health workers, being older (30–39 vs <30 y) (AOR=1.33, 95% CI=1.13–2.47), married (AOR=2.15, 95% CI=1.17–5.58) and having a larger HIV-positive daily caseload (20–49 vs <20) (AOR=1.98, 95% CI=1.07–3.64) predicted positive attitude towards reproductive rights of HIV-affected couples. Conclusions Health workers had limited knowledge of safer conception methods, but were supportive of the reproductive rights of HIV-positive couples. Health workers in Nigeria require training to effectively counsel couples on their reproductive rights, risks and options.

scholarly journals “I did not know about all these”: Perceptions regarding safer conception methods by women living with HIV in Gaborone, Botswana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242992
Author(s):  
Sarah A. Gutin ◽  
Gary W. Harper ◽  
Neo Moshashane ◽  
Kehumile Ramontshonyana ◽  
Atlang Mompe ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Partner Support ◽  
Interpretive Phenomenology ◽  
Safer Conception ◽  
Group Discussions ◽  
Women Living With Hiv ◽  
Safer Conception Methods ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Delivery Models

Various safer conception methods to limit HIV transmission risks can be offered in resource-constrained settings. However, implementation of safer conception services remains limited in many countries, including Botswana. Understanding perceptions about safer conception methods and the benefits and challenges to use can help with the development of policies, interventions, and service delivery models. Forty-five women living with HIV in the greater Gaborone, Botswana area participated in focus group discussions. Themes were analyzed using interpretive phenomenology. Despite low knowledge of specific safer conception methods that can be used to prevent transmission of HIV when trying to achieve pregnancy, there was noted interest in pre-exposure prophylaxis and vaginal insemination. Challenges to greater uptake were noted including a lack of knowledge about a range of SC methods, limited partner support and communication, provider stigma, health systems barriers, current policies, and the cultural acceptability of methods. Interventions will need to address these challenges and be responsive to the needs and reflect the realities of WLHIV who desire pregnancy in order for safer conception uptake to become a common practice.

scholarly journals Couples Living with HIV

2016 ◽  
Vol 16 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Violeta J. Rodriguez ◽  
Andrew Spence ◽  
Mallory Monda ◽  
JoNell Potter ◽  
Deborah Jones
Keyword(s):  
Perceived Risk ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
Hiv Status ◽  
Safer Conception ◽  
Reproductive Intentions ◽  
Hiv Prevention Strategies ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Men’S Involvement

Background: Desires to have children are not lessened by a woman’s HIV status. Couples may lack information to conceive safely, and men may be especially uninformed. This study examined reproductive intentions, practices, and attitudes among men in HIV-infected couples, including attitudes regarding the perceived risk of vertical and horizontal transmission, safer conception, and preconception planning. Methods: Men ( n = 12) in HIV-infected couples were interviewed regarding reproductive intentions, attitudes, and knowledge and qualitative assessments were coded for dominant themes. Results: Themes primarily addressed concerns about the health of the baby, men’s involvement in pregnancy, safer conception, concerns about HIV transmission and antiretroviral therapy, and HIV infection. Men lacked information on safer conception and newer HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Discussion: Gaps in knowledge regarding preconception practices among men in HIV-infected couples were identified. Results highlight men’s desire for involvement in preconception planning, and opportunities for providers to facilitate this practice and to increase patient education and the use of PrEP are discussed.

scholarly journals Perceived Risk of Mosquito-Borne Arboviruses in the Continental United States

Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1562
Author(s):  
Saul Lozano ◽  
Jonathan Day ◽  
Lilyana Ortega ◽  
Maggie Silver ◽  
Roxanne Connelly
Keyword(s):  
United States ◽  
Risk Perception ◽  
Vector Control ◽  
News Media ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
The United States ◽  
Transmission Risk ◽  
Accurate Information ◽  
Use Of Resources

The United States experienced local transmission of West Nile Virus (WNV) for the first time in 1999, and Zika Virus (ZIKV) in 2016. These introductions captured the public’s attention in varying degrees. The research presented here analyzes the disproportional perception of ZIKV risk compared to WNV transmission risk, by the public and vector control personnel. The risk perception of vector control was measured through purposive sampled interviews (24 interviews in 13 states; May 2020–June 2021), while the public’s perception was estimated from news publications (January 2000–December 2020), and Google searches (January 2004–December 2020). Over time, we observed a decrease in the frequency of press reporting and Google searches of both viruses with decreasing annual peaks in the summer. The highest peak of ZIKV news, and searches, surpassed that of WNV. We observed clear differences in the contents of the headlines for both viruses. We propose that the main reason in risk perception differences between the viruses were psychological. Zika infections (mosquito-borne and sexually transmitted) can result in devastating symptoms in fetuses and newborns, observations that frequently appeared in ZIKV-related headlines. Our results highlight the likely influence the news media has on risk perception and the need for public health agencies to play active roles in the conversation, helping disseminate timely and accurate information. Understanding the factors that shape risk perceptions of vector-borne diseases will hopefully lead to better use of resources by providing better guidance.

Post-abortion fertility desires, contraceptive uptake and unmet need for family planning: voices of post-abortion care clients in Tanzania

2020 ◽  
pp. 1-16
Author(s):  
Colin Baynes ◽  
Erick Yegon ◽  
Grace Lusiola ◽  
Japhet Achola ◽  
Rehema Kahando
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Pregnancy Intentions ◽  
Middle Income ◽  
Fertility Desires ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion ◽  
Contraceptive Uptake

Abstract Post-abortion care (PAC) integrates elements of care that are vital for women’s survival after abortion complications with intervention components that aid women in controlling their fertility, and provides an optimal window of opportunity to help women meet their family planning goals. Yet, incorporating quality family planning services remains a shortcoming of PAC services, particularly in low- and middle-income countries. This paper presents evidence from a mixed method study conducted in Tanzania that aimed at explaining factors that contribute to this challenge. Analysis of data obtained through client exit interviews quantified the level of unmet need for contraception among PAC clients and isolated the factors associated with post-abortion contraceptive uptake. Qualitative data analysis of interviews with a subset of these women explored the multi-level context in which post-abortion pregnancy intentions and contraceptive behaviours are formed. Approximately 30% of women interviewed (N=412) could recall receiving counselling on post-abortion family planning. Nearly two-thirds reported a desire to either space or limit childbearing. Of those who desired to space or limited childbearing, approximately 20% received a contraceptive method before discharge from PAC. The factors significantly associated with post-abortion contraceptive acceptance were completion of primary school, prior use of contraception, receipt of PAC at lower level facilities and recall of post-abortion family planning counselling. Qualitative analysis revealed different layers of contextual influences that shaped women’s fertility desires and contraceptive decision-making during PAC: individual (PAC client), spousal/partner-related, health service-related and societal. While results lend support to the concept that there are opportunities for services to address unmet need for post-abortion family planning, they also attest to the synergistic influences of individual, spousal, organizational and societal factors that influence whether they can be realized during PAC. Several strategies to do so emerged saliently from this analysis. These emphasize customized counselling to enable client–provider communication about fertility preferences, structural intervention aimed at empowering women to assert those objectives in family and health care settings, availability of information and services on post-abortion fertility and contraceptive eligibility in PAC settings and interventions to facilitate constructive spousal communication on family planning and contraceptive use, after abortion and in general.

Impact of HIV risk perception on both pre-exposure prophylaxis and condom use

2019 ◽  
pp. 135910531988392
Author(s):  
Marion Di Ciaccio ◽  
Luis Sagaon-Teyssier ◽  
Christel Protière ◽  
Mohamed Mimi ◽  
Marie Suzan-Monti ◽  
...  
Keyword(s):  
Risk Perception ◽  
High Risk ◽  
Condom Use ◽  
Hiv Risk ◽  
Health Behaviours ◽  
Two Dimensions ◽  
Hiv Risk Perception ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Trajectory Modelling

Risk perception is one of the several important factors impacting sexual health behaviours. This study investigated the evolution of HIV risk perception on pre-exposure prophylaxis adherence and condom use in men who have sex with men at high risk of HIV and associated factors. Group-based trajectory modelling helped in identifying patterns of risk perception, pre-exposure prophylaxis adherence and condom use over time. The association between the former and the latter two dimensions was then investigated. An estimated 61 per cent ( p < 0.001) of participants perceiving low risk and 100 per cent ( p < 0.001) of those perceiving high risk had systematic pre-exposure prophylaxis adherence, while an estimated 49 per cent ( p < 0.001) and 99.8 per cent ( p < 0.001), respectively, reported low-level condom use.

scholarly journals Strategies to prevent HIV transmission to serodiscordant couples

2015 ◽  
Vol 18 (suppl 1) ◽  
pp. 169-182 ◽  
Author(s):  
Ronaldo Campos Hallal ◽  
Juan Carlos Raxach ◽  
Nêmora Tregnago Barcellos ◽  
Ivia Maksud
Keyword(s):  
Hiv Transmission ◽  
Sexual Transmission ◽  
Sexual Practices ◽  
Transmission Risk ◽  
Prevention Policy ◽  
Serodiscordant Couples ◽  
Prevention Interventions ◽  
Single Strategy ◽  
Sexual Transmission Of Hiv ◽  
Exposure Prophylaxis

ABSTRACTIntroduction:The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples.Objective:This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil.Methods:A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde.Results:The articles recovered exhibit four main strategies: (1) condom; (2) reduction of risks in sexual practices; (3) use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP) and pre-exposure prophylaxis (PrEP); (4) risk reduction in reproduction.Discussion:TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies.Conclusions:When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

scholarly journals Safer Conception Methods and Counseling: Psychometric Evaluation of New Measures of Attitudes and Beliefs Among HIV Clients and Providers

2015 ◽  
Vol 20 (6) ◽  
pp. 1370-1381 ◽  
Author(s):  
Mahlet Atakilt Woldetsadik ◽  
Kathy Goggin ◽  
Vincent S. Staggs ◽  
Rhoda K. Wanyenze ◽  
Jolly Beyeza-Kashesya ◽  
...  
Keyword(s):  
Psychometric Evaluation ◽  
Attitudes And Beliefs ◽  
Safer Conception ◽  
Safer Conception Methods

HIV transmission risk behaviours among HIV-positive persons in serodiscordant relationships

2002 ◽  
Vol 13 (10) ◽  
pp. 677-682 ◽  
Author(s):  
Seth C Kalichman ◽  
David Rompa ◽  
Webster Luke ◽  
James Austin
Keyword(s):  
Hiv Transmission ◽  
Anal Intercourse ◽  
Transmission Risk ◽  
Hiv Positive ◽  
Sexually Active ◽  
Risk Behaviours ◽  
Unprotected Sexual Intercourse ◽  
Persons Living With Hiv ◽  
Hiv Transmission Risk ◽  
Hiv Positive Men

As many as one in three persons living with HIV-AIDS continue to practise unprotected sexual intercourse and these practices often occur with HIV-negative or unknown HIV serostatus (serodiscordant) partners. The current study examined the rates of HIV transmission risk behaviours in non-regular (e.g. casual) and regular (e.g. steady) serodiscordant relationships. HIV positive men ( n = 269) and women ( n = 114) responded to measures of demographic characteristics, health and mental health status, and sexual behaviours assessed in partner-by-partner interviews. 257 (67%) participants were sexually active in the preceding three months and 182 (71%) of the sexually active persons had engaged in vaginal or anal intercourse with serodiscordant partners. Comparisons of persons with non-regular ( n = 97) and regular ( n = 85) serodiscordant partners showed that overall rates of unprotected and protected intercourse were greater with regular partners than non-regular partners. Disclosure of HIV status to regular and non-regular serodiscordant partners did not appear to influence the pattern of results. Mathematical modelling showed that HIV transmission estimates over a one-year horizon were significantly greater for male regular partners of HIV-positive men than non-regular partners and there was a trend toward greater HIV transmission rates from HIV-positive men to their regular serodiscordant female partners compared to non-regular partners. Results suggest an urgent need for HIV transmission risk reduction interventions for HIV serodiscordant couples, particularly for couples in established, regular relationships.

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