Date Published: April 1, 2018
Author(s): Vaidehi Mujumdar, Doris Berman, Katherine R. Schafer.
People living with HIV (PLWH) have distinct needs when it comes to reproductive health, specifically regarding fertility, family planning, and pregnancy, and these needs are often complicated by HIV status. While there is ample research that focuses on reproductive health in PLWH through a quantitative lens, there is a lack of research using qualitative methods, namely, the narrative interview model. We searched PubMed and relevant abstracts to identify 72 articles published from 1997 to 2016 that described a qualitative framework for exploring the behaviors and perceptions regarding family planning, abortion, pregnancy, parenthood, fertility, and forced sterility in PLWH. The inclusion criteria initially showed 147 articles, which were further screened to exclude those that did not address fertility and family planning specifically. Our final sample of articles included articles related to qualitative research on reproductive attitudes, beliefs, and behaviors of PLWH. Several of these articles were mixed-methods analyses, but our focus was on the qualitative portion only. Further qualitative works in this area will not only contribute to gaps quantitative research in the field cannot capture by design, but also inform clinical practice, policy, and interventions through systematic, in-depth evaluation.
Qualitative research on reproductive behaviors and perceptions of people living with HIV (PLWH) is lacking compared to quantitative studies. Often in HIV research, qualitative studies are embedded within larger quantitative studies to further elucidate the data of the larger study [1–6].
We identified articles in the English language literature using PubMed using the following MeSH terms: HIV-positive, HIV seropositive, reproductive behavior, fertility, pregnancy, and qualitative. We also examined the references of articles identified through the selected articles. Though comprehensive, this process was not a formal systematic review. We chose not to conduct a formal systematic review because of the limited amount of qualitative research on reproductive behavior targeted to fertility, family planning (FP), and pregnancy in the United States. Included studies were primarily qualitative or mixed-methods with a qualitative component. Studies could involve behaviorally infected or perinatally infected participants, of both sexes. We focused on findings presented for females and males, but found that there were not as many studies focused on men. We did not limit our results to a particular geographic location, ethnic group, or country.
There is a small but rich pool of qualitative studies that provide some insight into how an HIV diagnosis may complicate beliefs, perceptions, and behaviors related to reproductive health. The findings described suggest a need for better understanding of the complex psychosocial milieu surrounding fertility, family planning, and reproduction for PLWH.