" First was to sit down and bring our minds together ". A qualitative study on safer conception decision-making among HIV sero-different couples in Zimbabwe.

Autor: Gitome S; Clinical Research Scientist, Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Musara P; Social Scientist, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Chitukuta M; Social Scientist, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Mhlanga F; Senior Lecturer, Department of Obstetrics and Gynecology, College of Health Sciences, University of Zimbabwe; Principal Investigator, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Mateveke B; Obstetrician & Gynecologist, Honorary lecturer, Department of Obstetrics and Gynecology, College of Health Sciences, University of Zimbabwe., Chirenda T; Registered Nurse/Midwife, Clinical Research Coordinator, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Mgodi N; Clinical Research Site Leader, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Mutero P; Social Scientist, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Matubu A; Laboratory Director, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Chareka G; Coordinator, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Chasakara C; Community Engagement Coordinator, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Murombedzi C; Research Pharmacist, University of Zimbabwe Clinical Trials Research Center, Harare, Zimbabwe., Makurumure T; Laboratory Director, Mercy-Care Fertility Centre, Harare, Zimbabwe., Smith-Hughes C; Associate Director of Evidence Translation, Department of Epidemiology and Biostatistics, San Francisco, CA, USA., Bukusi E; Senior Principal Clinical Research Scientist, Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Cohen CR; Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA., Shiboski S; Professor, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA., Darbes L; Professor, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA., Rutherford GW; Professor, Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA., Chirenje ZM; Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Professor, Department of Obstetrics and Gynecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe., Brown JM; Associate Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, USA; Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
Jazyk: angličtina
Zdroj: Sexual and reproductive health matters [Sex Reprod Health Matters] 2024 Dec; Vol. 32 (1), pp. 2366587. Date of Electronic Publication: 2024 Jul 15.
DOI: 10.1080/26410397.2024.2366587
Abstrakt: Decision-making on childbearing and safer conception use in HIV sero-different couples involves an intricate balance of individual desires and perceived HIV acquisition risk. This paper addresses an important knowledge gap regarding HIV sero-different couples' considerations and the relationship and power dynamics involved when deciding to use a safer conception method. Between February and June 2019, we conducted semi-structured in-depth interviews among 14 men and 17 women, representing 17 couples, who exited the SAFER study - a pilot study assessing the feasibility, acceptability and cost-effectiveness of a safer conception programme for HIV sero-different couples in Zimbabwe. All couples in SAFER were provided with a choice of safer conception methods and were followed for up to 12 months of pregnancy attempts and 3 months following pregnancy. While couples generally perceived their safer conception discussions to be easy and consensus-driven, the decision-making process also involved complex gender dynamics and trade-offs in relationship power, which resulted in differing interpretations of what constituted a joint or shared couple decision. Participants regarded effective couple communication as an essential component of and precursor to good safer conception conversations and requested additional training in couple communication. Couples relied on information from healthcare providers to kickstart their safer conception discussions. Safer conception programmes should address relationship power imbalances, promote effective couple communication and offer healthcare provider support to enable HIV sero-different couples to make informed choices about conception in a manner that upholds their safety and reproductive autonomy.
Databáze: MEDLINE