RESEARCH PAPER
Sexual and reproductive health needs and concerns of Iranian HIV-positive pregnant women during the COVID-19 pandemic
1
Department of Midwifery, Zeyinab (P.B.U.H.) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
2
Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3
Behavioral Disease Counselling Center of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Submission date: 2022-10-24
Final revision date: 2022-11-22
Acceptance date: 2022-11-29
Online publication date: 2025-05-05
Corresponding author
Leila Asadi
Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
HIV & AIDS Review 2025;24(2):148-157
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The COVID-19 pandemic has affected health and well-being of people throughout the world. Considering the complicated physical and mental problems of human immunodeficiency virus (HIV)-positive pregnant women, the aim of this study was to describe the sexual and reproductive health (SRH) needs and concerns of these women during the COVID-19 pandemic.
Material and methods:
This qualitative study was conducted with a content analysis approach to examine the SRH needs and worries of HIV-positive pregnant women during the COVID-19 pandemic. A total of 15 HIV-positive women participated in this study, including seven women with a history of pregnancy and eight women currently pregnant during the COVID-19 pandemic, presenting to Behavioral Diseases Counseling Center of Imam Khomeini Hospital Complex. In total, in-depth, 17 semi-structured, individual interviews were employed to collect data. Purposeful sampling was used with maximum diversity, and continued until reaching data saturation.
Results:
Content analysis of interviews was performed according to steps proposed by Zhang and Wildemuth, and resulted in three main categories and eight sub-categories. Main categories included increased fear of death, concern about the effect of COVID-19 on the fetus, and issues and problems in accessing appropriate prenatal services.
Conclusions:
The findings of the present study can help health planners implement more effective interventions to support and care of HIV-positive pregnant women during outbreaks, such as COVID-19 or similar health crises.
The COVID-19 pandemic has affected health and well-being of people throughout the world. Considering the complicated physical and mental problems of human immunodeficiency virus (HIV)-positive pregnant women, the aim of this study was to describe the sexual and reproductive health (SRH) needs and concerns of these women during the COVID-19 pandemic.
Material and methods:
This qualitative study was conducted with a content analysis approach to examine the SRH needs and worries of HIV-positive pregnant women during the COVID-19 pandemic. A total of 15 HIV-positive women participated in this study, including seven women with a history of pregnancy and eight women currently pregnant during the COVID-19 pandemic, presenting to Behavioral Diseases Counseling Center of Imam Khomeini Hospital Complex. In total, in-depth, 17 semi-structured, individual interviews were employed to collect data. Purposeful sampling was used with maximum diversity, and continued until reaching data saturation.
Results:
Content analysis of interviews was performed according to steps proposed by Zhang and Wildemuth, and resulted in three main categories and eight sub-categories. Main categories included increased fear of death, concern about the effect of COVID-19 on the fetus, and issues and problems in accessing appropriate prenatal services.
Conclusions:
The findings of the present study can help health planners implement more effective interventions to support and care of HIV-positive pregnant women during outbreaks, such as COVID-19 or similar health crises.
REFERENCES (55)
2.
Liu Y, Chen H, Tang K, Guo Y. Withdrawn: clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect 2020; S0163-4453(20)30109-2. DOI: 10.1016/j.jinf.2020.02.028.
3.
Ayenigbara IO. COVID-19: an international public health concern. Cent Asian J Glob Health 2020; 9: e466. DOI: 10.5195/cajgh.2020.466.
4.
Payne DC, Iblan I, Alqasrawi S, Al Nsour M, Rha B, Tohme RA, et al. Stillbirth during infection with Middle East respiratory syndrome coronavirus. J Infect Dis 2014; 209: 1870-1872.
5.
Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol 2020; 222: 521-531.
6.
Robertson CA, Lowther SA, Birch T, Tan C, Sorhage F, Stockman L, et al. SARS and pregnancy: a case report. Emerg Infect Dis 2004; 10: 345-348.
7.
Assiri A, Abedi GR, Al Masri M, Bin Saeed A, Gerber SI, Watson JT. Middle East respiratory syndrome coronavirus infection during pregnancy: a report of 5 cases from Saudi Arabia. Clin Infect Dis 2016; 63: 951-953.
8.
Kazeroni PA, Gouya MM, Tira M, Sargolzaiie M, Eybpoosh S, Majdfar Z, et al. Prevention of mother-to-child HIV transmission program in Iran. BMC Public Health 2021; 21: 483. DOI: 10.1186/s12889-021-10520-6.
9.
Tang K, Gaoshan J, Ahonsi B, Ali M, Bonet M, Broutet N, et al. Sexual and reproductive health (SRH): a key issue in the emergency response to the coronavirus disease (COVID-19) outbreak. Reprod Health 2020; 17: 59. DOI: 10.1186/s12978-020-0900-9.
10.
Jacobi CA, Atanga PN, Bin LK, Mbome VN, Akam W, Bogner JR, et al. HIV/AIDS-related stigma felt by people living with HIV from Buea, Cameroon. AIDS Care 2013; 25: 173-180.
11.
Juliastuti D, Dean J, Fitzgerald L. Sexual and reproductive health of women living with HIV in Muslim-majority countries: a systematic mixed studies review. BMC Int Health Hum Rights 2020; 20: 5. DOI: 10.1186/s12914-020-00225-z.
12.
Vrazo AC, Golin R, Fernando NB, Killam WP, Sharifi S, Phelps BR, et al. Adapting HIV services for pregnant and breastfeeding women, infants, children, adolescents and families in resource‐constrained settings during the COVID‐19 pandemic. J Int AIDS Soc 2020; 23: e25622. DOI: 10.1002/jia2.25622.
13.
Kapetanovic S, Dass-Brailsford P, Nora D, Talisman N. Mental health of HIV-seropositive women during pregnancy and postpartum period: a comprehensive literature review. AIDS Behav 2014; 18: 1152-1173.
14.
Knettel BA, Mwamba RN, Minja L, Goldston DB, Boshe J, Watt MH; KCMC Option B+ study team. Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania. AIDS 2020; 34: 1657-1664.
15.
Wedi CO, Kirtley S, Hopewell S, Corrigan R, Kennedy SH, Hemelaar J. Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis. Lancet HIV 2016; 3: e33-e48. DOI: 10.1016/S2352-3018(15)00207-6.
16.
Chilaka VN, Konje JC. HIV in pregnancy – an update. Eur J Obstet Gynecol Reprod Biol 2021; 256: 484-491.
17.
Minkoff H. Human immunodeficiency virus infection in pregnancy. Obstet Gynecol 2003; 101: 797-810.
18.
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins; 2017.
19.
Zhang Y, Wildemuth BM. Qualitative analysis of content. In: Applications of Social Research Methods to Questions in Information and Library Science. Libraries Unlimited; 2009, pp. 1-12.
20.
Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol 2020; 222: 415-426.
21.
Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y, et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol 2020; 55: 700-708.
22.
Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: a review. Fetal Pediatr Pathol 2020; 39: 246-250.
23.
Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis 2020; 20: 559-564.
24.
Kucirka LM, Norton A, Sheffield JS. Severity of COVID‐19 in pregnancy: a review of current evidence. Am J Reprod Immunol 2020; 84: e13332. DOI: 10.1111/aji.13332.
25.
Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID‐19 severity: a literature review. Rev Med Virol 2021; 31: 1-10.
26.
Fakari FR, Simbar M. Coronavirus pandemic and worries during pregnancy; a letter to editor. Arch Acad Emerg Med 2020; 8: e21.
27.
Rajkumar RP. COVID-19 and mental health: a review of the existing literature. Asian J Psychiatry 2020; 52: 102066. DOI: 10.1016/j.ajp.2020.102066.
28.
Kerwin JT. The effect of HIV infection risk beliefs on sexual behavior: scared straight or scared to death? 2014. Available at: https://sites.bu.edu/neudc/fil....
29.
Gilbert L, Walker L. ‘My biggest fear was that people would reject me once they knew my status…’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health Soc Care Community 2010; 18: 139-146.
30.
Pavlakis S, McAbee G, Roach ES. Fear and understanding in the time of COVID-19. Pediatr Neurol 2020; 111: 37-38.
31.
Nitpolprasert C, Anand T, Phanuphak N, Reiss P, Ananworanich J, Peay HL. A qualitative study of the impact of coronavirus disease (COVID‐19) on psychological and financial wellbeing and engagement in care among men who have sex with men living with HIV in Thailand. HIV Med 2022; 23: 227-236.
32.
Hall A, Joseph O, Devlin S, Kerman J, Schmitt J, Ridgway JP, McNulty MC. “That same stigma... that same hatred and negativity:” a qualitative study to understand stigma and medical mistrust experienced by people living with HIV diagnosed with COVID-19. BMC Infect Dis 2021; 21: 1066. DOI: 10.1186/s12879-021-06693-5.
33.
Vegt I, Kleinberg B. Women worry about family, men about the economy: gender differences in emotional responses to COVID-19. In: International Conference on Social Informatics. Springer; 2020, pp. 397-409.
34.
Karjadi TH, Maria S, Yunihastuti E, Widhani A, Kurniati N, Imran D. Knowledge, attitude, behavior, and socioeconomic conditions of people living with HIV in Indonesia during the COVID-19 pandemic: a cross-sectional study. HIV AIDS (Auckl) 2021; 13: 1045-1054.
35.
Madiba S. The impact of fear, secrecy, and stigma on parental disclosure of HIV status to children: a qualitative exploration with HIV positive parents attending an ART clinic in South Africa. Glob J Health Sci 2012; 5: 49-61.
36.
Behboodi-Moghadam Z, Khalajinia Z, Nasrabadi AR, Mohraz M, Gharacheh M. Pregnancy through the lens of Iranian women with HIV: a qualitative study. J Int Assoc Provid AIDS Care 2016; 15: 148-152.
37.
West NS, Ddaaki W, Nakyanjo N, Isabirye D, Nakubulwa R, Nalugoda F, et al. “A double stress”: the mental health impacts of the COVID-19 pandemic among people living with HIV in Rakai, Uganda. AIDS Behav 2022; 26: 261-265.
38.
Msomi N, Lessells R, Mlisana K, de Oliveira T. Africa: tackle HIV and COVID-19 together. Nature 2021; 600: 33-36.
39.
Burgoyne R, Renwick R. Social support and quality of life over time among adults living with HIV in the HAART era. Soc Sci Med 2004; 5: 1353-1366.
40.
Dow A, Dube Q, Pence BW, Van Rie A. Postpartum depression and HIV infection among women in Malawi. J Acquir Immune Defic Syndr (1999) 2014; 65: 359-365.
41.
Beaulière A, Touré S, Alexandre PK, Koné K, Pouhé A, Kouadio B, et al. The financial burden of morbidity in HIV-infected adults on antiretroviral therapy in Côte d’Ivoire. PLoS One 2010; 5: e11213. DOI: 10.1371/journal.pone.0011213.
42.
Eholié SP, Aoussi FE, Ouattara IS, Bissagnéné E, Anglaret X. HIV treatment and care in resource‐constrained environments: challenges for the next decade. J Int AIDS Soc 2012; 15: 17334. DOI: 10.7448/IAS.15.2.17334.
43.
Yousuf A, Musa R, Isa MLM, Arifin SRM. Anxiety and depression among women living with HIV: prevalence and correlations. Clin Pract Epidemiol Ment Health 2020; 16: 59-66.
44.
Benoit AC, Light L, Burchell AN, Gardner S, Rourke SB, Wobeser W, Loutfy MR; OHTN Cohort Study Team; Ontario CHIWOS Research Team. Demographic and clinical factors correlating with high levels of psychological distress in HIV-positive women living in Ontario, Canada. AIDS Care 2014; 26: 694-701.
45.
Fletcher FE, Sherwood NR, Rice WS, Yigit I, Ross SN, Wilson TE, et al. Resilience and HIV treatment outcomes among women living with HIV in the United States: a mixed-methods analysis. AIDS Patient Care STDS 2020; 34: 356-366.
46.
Devlin SA, Johnson AK, McNulty MC, Joseph OL, Hall A, Ridgway JP. “Even if I’m undetectable, I just feel like I would die”: a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL. BMC Womens Health 2022; 22: 218. DOI: 10.1186/s12905-022-01812-z.
47.
Chinkonde JR, Sundby J, Martinson F. The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out. Reprod Health Matters 2009; 17: 143-151.
48.
Bwirire LD, Fitzgerald M, Zachariah R, Chikafa V, Massaquoi M, Moens M, et al. Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi. Trans R Soc Trop Med Hyg 2008; 102: 1195-1200.
49.
Bennett DS, Hersh J, Herres J, Foster J. HIV-related stigma, shame, and avoidant coping: Risk factors for internalizing symptoms among youth living with HIV? Child Psychiatry Hum Dev 2016; 47: 657-664.
50.
Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, Ekstrand ML. HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med 2008; 67: 1225-1235.
51.
Naji SA, Abedi H, Sasani L. The experience of social stigma in AIDS patients: a phenomenological study. Journal of Sabzevar University of Medical Sciences 2014; 20: 487-495.
52.
Katz IT, Ryu AE, Onuegbu AG, Psaros C, Weiser SD, Bangsberg DR, Tsai AC. Impact of HIV‐related stigma on treatment adherence: systematic review and meta‐synthesis. J Int AIDS Soc 2013; 16 (3 Suppl 2): 18640. DOI: 10.7448/IAS.16.3.18640.
53.
Dietz E, Clum GA, Chung SE, Leonard L, Murphy DA, Perez LV, et al. Adherence to scheduled appointments among HIV-infected female youth in five US cities. J Adolesc Health 2010; 46: 278-283.
54.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet 2004; 363: 1415-1421.
55.
Dunkle KL, Decker MR. Gender‐based violence and HIV: reviewing the evidence for links and causal pathways in the general population and high‐risk groups. Am J Reprod Immunol 2013; 69: 20-26.
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