Special Studies Project: Influences in Fertility Decisions among HIV positive individuals in Lilongwe, Malawi & Barriers to Uptake and Continued use of Modern Contraceptive Methods among HIV positive individuals in Lilongwe, Malawi Open Access

Hoagland, Alexandra Brierley (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/kw52j866p?locale=en%5D
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Abstract

Background: HIV positive Malawians of reproductive age account for approximately 10.8% of the population. HIV positive individuals face challenges when whether to continue, limit or cease their fertility. Studies indicate Malawians are interested in modern contraceptive methods but uptake of methods remains low. This study looks to investigate the influenced in fertility decisions and barriers to uptake and continued use of modern contraceptives among HIV positive individuals living in Lilongwe, Malawi.

Methods: From May to July 2012, a reproductive knowledge, attitudes and practices study was conducted at two Lighthouse Trust clinics in Lilongwe, Malawi. All participants were HIV positive men and women enrolled in ART programs. Thirteen single sex focus group discussions and eight in-depth interviews were used for the purposes of this study. A secondary data analysis was conducted to barriers to uptake and continued use of modern contraceptive methods in the context of HIV.

Findings: The study population identified five key influences in their fertility decision process; partner fertility desire, concern of transmission of HIV, financial considerations, current number of children within the couple and influences outside the partnership such as friends and family. For HIV positive individuals interested in limiting or ceasing their fertility barriers to uptake and continued use of modern contraceptives prevent people from reaching their fertility goals. The study population identified four barriers to their uptake of modern contraceptive; misconceptions relating to contraceptive methods and their potential side effects, condom use, access to family planning services, and male influence on the uptake of contraceptives.

Discussion: Influences in fertility decisions and barriers to uptake and continued use of modern contraceptive methods identified in this study show the unique challenges facing HIV positive person in Lilongwe, Malawi. Although some of the findings were similar to influences and barriers facing HIV negative individuals in Malawi, they were augmented for HIV positive individuals.

Table of Contents

Table of Contents

Special Studies Project: Influences in Fertility Decision Making among HIV Positive Individuals in Lilongwe, Malawi & Barriers to uptake and continued use of modern contraceptive methods among HIV positive individuals in Lilongwe, Malawi............................................................................................................................................................ 1

Introduction:....................................................................................................................................... 1

Background:........................................................................................................................................ 1

Study questions:.................................................................................................................................. 4

Data Collection and Analysis:.................................................................................................................. 5

Findings:............................................................................................................................................. 8

Discussion:.......................................................................................................................................... 9

Student Involvement:............................................................................................................................ 10

References:......................................................................................................................................... 12

Influences in Fertility Decisions among HIV positive persons in Lilongwe, Malawi: a qualitative study........................................................................... 14

Abstract:............................................................................................................................................ 14

Introduction:....................................................................................................................................... 15

Methods:............................................................................................................................................ 16

Findings:............................................................................................................................................. 18

Partner Influence:................................................................................................................................. 18

Concerns about Transmission:................................................................................................................. 21

Financial Factors:................................................................................................................................. 23

Current number of children:.................................................................................................................... 24

Influences outside the couple:................................................................................................................ 26

Discussion:.......................................................................................................................................... 27

References:......................................................................................................................................... 32

Barriers to Modern Contraceptive uptake and continued use among HIV positive individuals in Lilongwe, Malawi........................................................... 34

Abstract:............................................................................................................................................ 34

Introduction:....................................................................................................................................... 35

Methods:............................................................................................................................................ 36

Findings:............................................................................................................................................. 39

Misconceptions and Side Effects:............................................................................................................ 39

Condom Use:....................................................................................................................................... 43

Access to Family Planning Services:......................................................................................................... 44

Male Influence on Contraceptive Uptake:.................................................................................................. 45

Discussion:.......................................................................................................................................... 47

References:......................................................................................................................................... 52

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