Men’s and women’s roles in decision making about abortion in the context of HIV

Abstract

Objective: Mother-to-child transmission of HIV is a matter of global concern but is particularly serious in Zimbabwe. A number of strategies have been identified to limit the risk of mother-to-child transmission, including abortion. The aim of the current study was to assess men’s and women’s roles in decision making about abortion in a setting with a high prevalence of HIV.

Methods: Qualitative research based on eight focus group discussions was conducted among adult men and women in Gokwe North District, Zimbabwe.

Results: Both men and women expressed strong, negative attitudes towards abortion. Often, HIV-infected women considered carrying their pregnancy to term so as to fulfil societal and cultural expectations of childbirth after marriage. Termination of pregnancy by HIV-infected women was discouraged due to the availability of highly active antiretroviral drugs. Fear of giving birth to a sick and HIV-infected child, however, remained high. Also, the restricted legal environment appeared to complicate HIV-positive women’s decisions to abort. Male involvement in decision making about abortion was relatively limited; if women opted for termination of pregnancy they were likely to do so secretly without obtaining their partner’s consent.

Conclusions: In the context of HIV, it is important for prevention programmes to target both men and women in order to reduce the risk of mother-to-child transmission.

摘要

目的：艾滋病母婴传播是全球关注的问题, 但在津巴布韦尤为严重。已经确定了一些限制母婴传播风险的策略, 包括人工流产。当前研究的目的是评估男性和女性在HIV高流行背景下流产决策中的作用。

方法：在津巴布韦Gokwe北区的成年男性和女性中进行了基于八个重点小组讨论的定性研究。

结果：男性和女性对流产都表现出强烈的消极态度。通常情况下, 感染HIV的女性考虑怀孕至足月, 以满足社会和文化对婚后生育的期望。由于可获得高活性抗逆转录病毒药物, 不鼓励艾滋病病毒感染女性终止妊娠。然而, 对生出患病和感染艾滋病毒的孩子的恐惧仍然很强烈。此外, 有限的法律环境似乎使艾滋病毒抗体阳性女性放弃治疗的决定复杂化。男性在流产决策的参与相对有限；如果女性选择终止妊娠, 她们很可能在未征得伴侣同意的情况下秘密进行。

结论：在艾滋病方面, 重要的是制定针对男性和女性的预防方案, 以减少母婴传播的风险。

Keywords:

• Abortion
• Africa
• communication
• decision making
• HIV
• male partner
• mother-to-child transmission of HIV

Acknowledgements

We wish to acknowledge the support of the DST/NRF South African Research Chair in Economic Development at the University of KwaZulu-Natal. We would like to thank all participants for their willingness to be interviewed for the study.

Disclosure statement

No potential conflict of interest was reported by the authors.