Correlates of unintended pregnancies among HIV+ women.

Abstract

Pregnancies among HIV-positive women can lead to adverse maternal and child outcomes with added negative impact on the health system. This study intended to explore the correlates of unintended pregnancies among HIV-positive women. After obtaining written informed consent, in-depth interviews (IDI) were conducted among HIV-positive women of 18-49 years age registered at the four anti-retroviral therapy (ART) centers of erstwhile Visakhapatnam district from 1^st July 2020 to 30^th June 2022 who were ever pregnant during this period by using a pre-validated interview guide. IDI were conducted until data saturation at each ART center. A focus group discussion was conducted with counsellors from integrated counselling and testing centers and members of Prevention of Mother To Child Transmission Advisory committee. The confidentiality of the participants was strictly maintained. A total of 17 HIV-positive pregnant women were interviewed. Most women (13) knew their HIV status before becoming currently pregnant. Among these 13 women, nine were intentional pregnancies. The "patient perspective" included desire for children, challenges related to contraceptive usage, confidence that the use of ART prevents transmission to offspring, and financial reasons. Patient-related factors such as late reporting, availability of contraceptive services, and assurance given to ensure ART compliance were provider-related perspectives on pregnancies among HIV-positive women. HIV positive couples either concordant or discordant, are confident of the effectiveness of the Anti retroviral treatment that they desire to have children like normal couples. Awareness and availability of dual contraception needs to be strengthened at ART centres.