Perspectives about childbearing and pregnancy planning amongst people living with HIV in Gaborone, Botswana

Abstract

Despite advances in clinical care, safer conception services are not utilised in many high HIV prevalence countries, including Botswana. We conducted in-depth interviews with 10 HIV healthcare providers and 10 women living with HIV to develop a deeper understanding of attitudes surrounding childbearing and pregnancy planning. Interviews were analysed using a phenomenological approach. Providers felt it was a human right and normative for women living with HIV to have children but also expressed concern about women living with HIV having children. Women themselves anticipated stigma from providers regarding childbearing, although most described supportive care and had not experienced stigmatising treatment. Although providers believed pregnancies amongst women living with HIV were unplanned, women described discussing pregnancy desires with sexual partners. Despite providers voicing a rights-based approach to childbearing amongst women living with HIV, hesitancy towards pregnancy remains. This is felt by women living with HIV and perceived as stigma, which may make them less likely to seek fertility and safer conception advice. Safer conception interventions are unlikely to be successful if women do not feel comfortable discussing childbearing with health-care providers.

Keywords:

• Safer conception
• childbearing
• pregnancy planning
• Botswana
• HIV

Additional information

Funding

This study would not have been possible without the generous financial support of various schools and institutes at the University of Michigan, including the International Institute, the African Studies Center, the Office of Global Public Health at the School of Public Health and the Horace H. Rackham Graduate School. This research was also supported in part by a Eunice Kennedy Shriver National Institute of Child Health and Human Development training grant (T32 HD007339) to the Population Studies Center at the University of Michigan. None of the funders mentioned here played any role in the design of the study, data collection, analysis, interpretation of data or manuscript writing.