Document Type
Article
Publication Date
2-20-2018
Identifier
DOI: 10.1371/journal.pone.0192902; PMCID: PMC5819785
Abstract
INTRODUCTION: Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.
METHODS: 400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.
RESULTS: 75% of the sample was female; 61% were on antiretroviral therapy; and 61% had HIV-negative or unknown status partners. Nearly all (98%) reported the desire to discuss childbearing intentions with their HIV provider; however, only 44% reported such discussions, the minority (28%) of which was initiated by the provider. Issues discussed with HIV providers included: HIV transmission risk to partner (30%), HIV transmission risk to child (30%), and how to prevent transmission to the child (27%); only 8% discussed safer conception methods. Regression analysis showed that those who had communicated with providers about childbearing were more likely to have been diagnosed with HIV for a longer period [OR (95% CI) = 1.09 (1.03, 1.15)], while greater internalized childbearing stigma was associated with lower odds of this communication [OR (95% CI) = 0.70 (0.49, 0.99)], after controlling for all bivariate correlates and basic demographics.
CONCLUSIONS: Communication between HIV clients and providers about childbearing needs is poor and associated with stigma. Innovations to mitigate stigma among clients as well as training to improve health worker communication and skills related to safer conception counseling is needed.
Journal Title
PLoS One
Volume
13
Issue
2
First Page
0192902
Last Page
0192902
MeSH Keywords
Adult; Anti-HIV Agents; Female; HIV Infections; Health Communication; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Infectious Disease Transmission, Vertical; Logistic Models; Male; Pregnancy; Pregnancy Complications, Infectious; Professional-Patient Relations; Reproduction; Self Report; Social Stigma; Uganda
Keywords
Anti-HIV Agents; HIV Infections; Health Communication; Infectious Disease Transmission; Pregnancy Complications; Reproduction; Social Stigma; Uganda
Recommended Citation
Beyeza-Kashesya J, Wanyenze RK, Goggin K, et al. Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda. PLoS One. 2018;13(2):e0192902. Published 2018 Feb 20. doi:10.1371/journal.pone.0192902
Included in
International Public Health Commons, Maternal and Child Health Commons, Public Health Education and Promotion Commons, Women's Health Commons
Comments
Grant support
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publisher's Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192902