RESEARCH PAPER
Marital life, sexual relations, and fertility health in Iranian HIV/AIDS patients: a qualitative study
More details
Hide details
1
Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2
Public Health Nursing Department, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran
Submission date: 2019-04-05
Final revision date: 2019-04-22
Acceptance date: 2019-04-23
Publication date: 2019-09-06
HIV & AIDS Review 2019;18(3):207-214
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Although the rights, needs, and interests of reproductive and sexual health in human immunodeficiency virus (HIV)-positive women and men are similar to those of HIV-negative people, some biological and social differences require them to be given special attention. The aim of this qualitative study was exploring the sexual behaviours and reproductive health of people with HIV/acquired immunodeficiency syndrome (AIDS).
Material and methods:
The data collected in this study included semi-structured, face-to-face and audio recorded interviews with 14 HIV/AIDS patients referring to the Behavioural Disease Counselling Centres of Tehran and Rasht (Iran). Purposeful sampling with maximum variation was used to select participants. The duration of the interviews was between 40 and 75 minutes. MAXQDA10 software was used to organise and manage the data, and conventional concept analysis was used to examine the data.
Results:
Fifty-seven per cent of the participants were male and 64% were married. More than 90% of the participants had not had children since the disease. In the analysis of interviews, the following three themes were extracted: stressful marriage, sexual activity, and childbearing.
Conclusions:
The findings of the study, not only in the field of health care management but also at the social level, have applications supporting people living with HIV/AIDS as well as non-affected people.
REFERENCES (58)
1.
Auerbach JD. Principles of positive prevention. J Acquir Immune Defic Syndr 2004; 37 Suppl 2: S122-S125.
2.
Coetzee D, Hildebrand K, Boulle A, et al. Outcomes after two years of providing antiretroviral treatment in Khayelitsha, South Africa. AIDS 2004; 18: 887-895.
3.
Smith DJ, Mbakwem BC. Antiretroviral therapy and reproductive life projects: mitigating the stigma of AIDS in Nigeria. Soc Sci Med 2010; 71: 345-352.
4.
Global HIV & AIDS statistics – 2018 fact sheet. UNAIDS. Available at: www.unaids.org/en/resources/fact-sheet.
5.
Lewis JJ, Ronsmans C, Ezeh A, Gregson S. The population impact of HIV on fertility in sub-Saharan Africa. AIDS 2004; 18: S35-S43.
6.
Chen JL, Philips KA, Kanouse DE, Collins RL, Miu A. Fertility desires and intentions of HIV-positive men and women. Fam Plann Perspect 2001; 33: 144-152, 165.
7.
Segurado AC, Paiva V. Rights of HIV positive people to sexual and reproductive health: parenthood. Reprod Health Matters 2007; 15 (29 Suppl): 27-45.
8.
Sexual and reproductive health needs and preferences of people living with HIV/AIDS in Southern Nations Nationalities and Peoples Region. Addis Ababa University.
9.
Hajizadeh, S., et al., Fertility Intentions of HIV Patients who Referred to Behavioral Clinics of Universities of Medical Sciences in Tehran. J Isfahan Medical School 2012; 29: 2427-2436.
10.
Gruskin S, Ferguson L, O’Malley J. Ensuring sexual and reproductive health for people living with HIV: an overview of key human rights, policy and health systems issues. Reprod Health Matters 2007; 15 (20 Suppl): 4-26.
11.
Beyeza-Kashesya J, Kaharuza F, Mirembe F, Neema S, Ekstrom AM, Kulane A. The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda. Afr Health Sci 2009; 9: 2-12.
12.
Nedjat S, Moazen B, Rezaei F, et al. Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study. Int J Health Policy Manag 2015; 4: 591-598.
13.
Abasiubong F, Udoh SB, Idung AU, et al. Attitudes and sexual behaviours of unmarried people with HIV/AIDS living in the Niger Delta region of Nigeria. Ment Health Fam Med 2012; 9: 225-232.
14.
King R, Katuntu D, Lifshay J, et al. Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda. AIDS Behav 2008; 12: 232-243.
15.
Gaede B, Majeke S, Modeste RRM, et al. Social support and health behaviour in women living with HIV in KwaZulu-Natal. SAHARA J 2006; 3: 362-368.
16.
Kalichman SC, Ntseane D, Nthomang K, et al. Recent multiple sexual partners and HIV transmission risks among people living with HIV/AIDS in Botswana. Sex Transm Infect 2007; 83: 371-375.
17.
Bateganya M, Colfax G, Shafer LA, et al. Antiretroviral therapy and sexual behavior: a comparative study between antiretroviral-naive and-experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda. AIDS Patient Care STDS 2005; 19: 760-768.
18.
Niccolai LM, D’Entremont D, Pritchett EN, Wagner K. Unprotected intercourse among people living with HIV/AIDS: the importance of partnership characteristics. AIDS Care 2006; 18: 801-807.
19.
Eisele TP, Mathews C, Chopra M, et al. Changes in risk behavior among HIV-positive patients during their first year of antiretroviral therapy in Cape Town South Africa. AIDS Behav 2009; 13: 1097-1105.
20.
Courtenay-Quirk C, Zhang J, Wolitski RJ. Intentional abstinence among homeless and unstably housed persons living with HIV/AIDS. AIDS Behav 2009; 13: 1119-1128.
21.
MacLachlan EW. Factors that influence risk behavior in HIV infected women receiving antiretroviral therapy in Kampala and Masaka, Uganda. 2007.
22.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105-112.
23.
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Lippincott Williams & Wilkins, 2011.
24.
Aghasi M, Fallah, F. Iranian youth’s attitude towards marriage, spouse’s choice and family formation. Women’s Research Special Report. Institute of Humanities and Cultural Studies 2016; 6: 1-27 [In Persian].
25.
Parvin S, Eslamian A. The lived experience of women living with HIV in social relationships. Woman in Development and Politics 2014; 12: 207-228 [In Persian].
26.
Fallahi F, Tavafian S, Yaghmaie F, Hajizadeh E. Consequences of living with HIV/AIDS: a qualitative study. Journal of the Iranian Institute for Health Sciences Research (Payesh) 2013; 12: 243-253 [In Persian].
27.
Abachi A, Behravan H. The analysis of stigma impact on quality of life in patients with HIV/AIDS: a phenomenological study. J Qual Res Health Sci 2013; 2: 158-172 [In Persian].
28.
Rispel LC, Metcalf CA, Moody K, Cloete A, Caswell G. Sexual relations and childbearing decisions of HIV-discordant couples: an exploratory study in South Africa and Tanzania. Reprod Health Matters 2011; 19: 184-193.
29.
Hajizadeh Sh, Nedjat S, Majdzadeh R, et al. High-risk behaviors of HIV positive individuals referred to Behavioral Counselling Centers of Universities of Medical Sciences in Tehran. Journal of School of Public Health and Institute of Public Health Research 2012; 10: 65-76 [In Persian].
30.
Johnson P. Risky health behaviors and neurocognitive function among people living with HIV. University of Southern California, 2009.
31.
Cleland J, Sinding S. What would Malthus say about AIDS in Africa? Lancet 2005; 366: 1899-1901.
32.
Amoran O, Ladi-Akinyemi T. Sexual risk history and condom use among people living with HIV/AIDS in Ogun State, Nigeria. J Sex Med 2012; 9: 997-1004.
33.
Dessie Y, Deresa M. Sexual practices of HIV-positive individuals attending antiretroviral treatment (ART) in Addis Ababa public hospitals: findings from in-depth interview. Pan Afr Med J 2012; 13: 80.
34.
Adeniyi OV, Ajayi AI, Selanto-Chairman N, et al. Demographic, clinical and behavioural determinants of HIV serostatus non-disclosure to sex partners among HIV-infected pregnant women in the eastern cape, South Africa. PLoS One 2017; 12: e0181730.
35.
Esmaelzadeh-Saeieh S, Ebadi A, Mahmoodi Z, et al. Barriers to disclosure of disease in HIV-infected women: a qualitative study. HIV AIDS Rev 2018; 17: 12-17.
36.
Cooper D, Moodley J, Zweigenthal V, et al. Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services. AIDS Behav 2009; 13 Suppl 1: 38-46.
37.
Crepaz N, Marks G. Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care 2003; 15: 379-387.
38.
Gogna ML, Pecheny MM, Ibarlucía I, et al. The reproductive needs and rights of people living with HIV in Argentina: health service users’ and providers’ perspectives. Soc Sci Med 2009; 69: 813-820.
39.
Panozzo L, Battegay M, Friedl A, Vernazza PL; Swiss Cohort Study. High risk behaviour and fertility desires among heterosexual HIV-positive patients with a serodiscordant partner – two challenging issues. Swiss Med Wkly 2003; 133: 124-127.
40.
Fallahi H, et al. HIV/AIDS people’s perspectives on barriers to condom use: a qualitative research. Payesh Quarterly 2012; 11: 831-840 [In Persian].
41.
Ngure K, Mugo N, Celum C, et al. A qualitative study of barriers to consistent condom use among HIV-1 serodiscordant couples in Kenya. AIDS Care 2012; 24: 509-516.
42.
Cunha CB, De Boni RB, Guimarães MR, et al. Unprotected sex among men who have sex with men living with HIV in Brazil: a cross-sectional study in Rio de Janeiro. BMC Public Health 2014; 14: 379.
43.
Halkitis PN, Parsons JT, Wilton L. Barebacking among gay and bisexual men in New York City: Explanations for the emergence of intentional unsafe behavior. Arch Sex Behav 2003; 32: 351-357.
44.
Loutfy M, Raboud J, Wong J, et al., High prevalence of unintended pregnancies in HIV-positive women of reproductive age in Ontario, Canada: a retrospective study. HIV Med 2012; 13: 107-117.
45.
Wilcher R, Cates W Jr. Reaching the underserved: family planning for women with HIV. Studies in Family Planning 2010; 41: 125-128.
46.
Wanyenze RK, Tumwesigye NM, Kindyomunda R, et al. Uptake of family planning methods and unplanned pregnancies among HIV-infected individuals: a cross-sectional survey among clients at HIV clinics in Uganda. J Int AIDS Soc 2011; 14: 35.
47.
Smits AK, Goergen CA, Delaney JA, et al. Contraceptive use and pregnancy decision making among women with HIV. AIDS Patient Care STDS 1999; 13: 739-746.
48.
Ezeanolue EE, Wodi AP, Patel R, et al. Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: experience of an urban tertiary center. Journal of Adolescent Health 2006; 38: 719-725.
49.
Loutfy MR, Hart TA, Mohammed SS, et al. Fertility desires and intentions of HIV-positive women of reproductive age in Ontario, Canada: a cross-sectional study. PLoS One 2009; 4: e7925.
50.
Oladapo OT, Daniel OJ, Odusoga OL, Ayoola-Sotubo O, et al. Fertility desires and intentions of HIV-positive patients at a suburban specialist center. J Natl Med Assoc 2005; 97: 1672-1681.
51.
Grzeszczuk J, Wroblewska A, Firląg-Burkacka E, Kowalska JD. The characteristics of HIV serodiscordant couples consulted at the HIV Out-Patient Clinic in Warsaw. HIV AIDS Rev 2017; 16: 58-60.
52.
Glynn JR, Buvé A, Caraël M, et al. Decreased fertility among HIV-1-infected women attending antenatal clinics in three African cities. J Acquir Immune Defic Syndr 2000; 25: 345-352.
53.
Carpenter LM, Nakiyingi JS, Ruberantwari A, et al. Estimates of the impact of HIV infection on fertility in a rural Ugandan population cohort. Health Transition Review 1997; 7 (Suppl 2): 113-126.
54.
Dabash R. Sexual and reproductive health needs of women and adolescent girls living with HIV. Research report on qualitative findings from Brazil Ethiopia and the Ukraine. 2006.
55.
Kirshenbaum SB, Hirky AE, Correale J, et al. “Throwing the dice”: pregnancy decision-making among HIV-positive women in four U.S. cities. Perspect Sex Reproduct Health 2004; 36: 106-113.
56.
Behboodi-Moghadam Z, Esmaelzadeh S, Ebadi A, Nikbakht Nasrabadi A. Development and psychometric evaluation of a reproductive health assessment scale for HIV-positive women. Shiraz E Medical Journal 2016; 17.
57.
Loutfy MR, Blitz S, Zhang Y. Self-reported preconception care of HIV-positive women of reproductive potential: a retrospective study. Journal of the International Association of Providers of AIDS Care (JIAPAC) 2014; 13: 424-433.
58.
Wagner GJ, Ryan GW. Relationship between routinization of daily behaviors and medication adherence in HIV-positive drug users. AIDS Patient Care STDS 2004; 18: 385-393.