Procreation and child desire of women living with HIV in Abidjan, Cote d'Ivoire

The child desire of HIV-positive women undergoes several alterations. The present study describes those along with the defence mechanisms and fantasies experienced by such women in Abidjan, Côte d'Ivoire, and the impact of the psychological intervention. We employed a story case approach, that is, we sought information concerning the women's background and personal history along with individual interviews. The investigation was based on a sample of six story cases extracted from a cohort of HIV-positive women who participated in clinical psychology consultations, as part of a research programme aimed at reducing mother-to-child transmission of HIV (ANRS, 049 a trial). The time of conduction of the clinical cohort study was 18 months. Each woman was seen two to four times in a period of 2 months. In general, the child women of HIV-positive women strengthened. This was true for the women who learned their positive serostatus during pregnancy, as well as for those who had prior knowledge of it. In order to cope with the anxieties elicited by their positive serostatus, which implied that they may either give birth to an infected child or not be able to bear any more children, the women unconsciously set forth defence mechanisms, such as denial, aggressive projection, rationalization and regression. The psychological intervention thus becomes a necessary outlet. As a result, it is recommended that some psychosocial interventions be included in actions that are undertaken on behalf of HIV-positive women. Such interventions, however, should take into account the patients' culture.