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Exploring the Reproductive Decision-making Process of HIV-positive Women in County Victoria, Trinidad and Tobago

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Objective: The community-based Prevention of Mother to Child Transmission (PMTCT) programme in Trinidad and Tobago offers care and support to HIV-positive (HIV+) pregnant women and their families for their lifetime.  This study explored the factors influencing repeat childbearing by PMTCT enrolees. 

Method: In-depth qualitative interviews were conducted with purposively selected and consenting HIV+ women who enrolled in the PMTCT programme (n = 10) in County Victoria and four healthcare workers (HCWs). Transcribed interviews were analysed and coded using thematic content analysis.

Results: Though women desired children and motherhood, some did not intend to conceive fearing HIV, age-related ill-health and vertical transmission. Others had not considered pregnancy and conceived through accident and partners’ disregard for the women’s HIV status, particularly if such partners were inebriated.  Partners’ desire for children, especially in new relationships, led to planned pregnancies. Nine of the 10 HIV+ women did not seek family planning advice; the one that did was advised about partner infection but not risk reduction, vertical transmission or reinfection. Though HCWs supported HIV+ women’s reproductive rights, they agreed that HCWs stigmatized and discriminated against HIV+ mothers.  Both parties saw the PMTCT programme as an effective programme in vastly reducing HIV transmission from mother to child.  

Conclusion: The PMTCT programme and family planning services should be integrated with tailored services toward HIV+ women and their partners to help them safely achieve their reproductive goals.  Healthcare workers should be given training and skillsets to address stigma and discrimination against persons infected with HIV/AIDS within Trinidad and Tobago’s health workforce. 

June 10, 2014
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