Parenting intentions of young gay and other men who have sex with men living with HIV in Mexico City, Mexico Open Access
Camp, Daniel (Spring 2020)
Published
Abstract
Background: Young gay and other men who have sex with men (YGMSM) are disproportionately affected by HIV in Mexico. Men in Mexico typically start thinking about fatherhood in late adolescence; however, little is known about Mexican YGMSM’s thoughts about childbearing. This issue is complicated by both their sexual identity and their HIV serostatus; however, reproductive justice theory holds that individuals – regardless of gender or sexual orientation – have a right to bear and raise healthy children. Within this framework, we sought to explore conceptualizations of fatherhood and parenting desires among YGMSM living with HIV in Mexico City.
Methods: We conducted 16 in-depth qualitative interviews with YGMSM living with HIV in Mexico City. Participants were recruited from two large HIV clinics. Domains of the questionnaire included: (1) parenting desires, (2) preferences about different methods (e.g., adoption, in-vitro fertilization), and (3) perceived barriers. A modified grounded theory approach was used for coding and qualitative analysis.
Results: Participants ranged in age from 17 to 21 (mean 19.3) years, and had been diagnosed with HIV for an average of 15 months (range:15 days to 6 years). Most participants expressed a desire to have a child in the future, but were uninformed as to their options for doing so. Participants largely preferred adoption as a mechanism for fathering a child, citing a perceived risk of HIV transmission as a deterrent to artificial insemination and other assisted reproductive technologies. However, some participants expressed a desire to have a child that was genetically their own, but shared doubts as to whether this would be feasible. The majority of participants stated that the topic of childbearing had never come up during the course of their routine HIV care.
Conclusion: YGMSM living with HIV in Mexico City are interested in having children. Our findings suggest a role for future interventions, both to inform YGMSM living with HIV about potential avenues for pursuing parenthood, as well as with to support HIV care providers to initiate discussions about future parenting with their YGMSM patients.
Table of Contents
CHAPTER 1: INTRODUCTION.................................................................................... 1
INTRODUCTION AND RATIONALE..................................................................................................1
PROBLEM STATEMENT ..................................................................................................................5
STATEMENT OF PURPOSE ..............................................................................................................6
RESEARCH QUESTIONS..................................................................................................................7
SIGNIFICANCE STATEMENT...........................................................................................................7
CHAPTER 2: LITERATURE REVIEW........................................................................ 8
EPIDEMIOLOGY OF HIV IN MEXICO AMONG YOUNG GMSM ......................................................8
LGBTQ RIGHTS IN MEXICO .........................................................................................................9
PARENTING ..................................................................................................................................10
FATHERHOOD IN MEXICO........................................................................................................10
GMSM AS PARENTS.................................................................................................................11
PLWH AS PARENTS..................................................................................................................16
CHAPTER 3: MANUSCRIPT....................................................................................... 20
STUDENT CONTRIBUTION............................................................................................................20
ABSTRACT ...................................................................................................................................21
INTRODUCTION ............................................................................................................................22
METHODS ....................................................................................................................................26
CONTEXT...................................................................................................................................26
PARTICIPANTS ...........................................................................................................................27
DESIGN.................................................................................................................................. .. 27
THEMATIC ANALYSIS..................................................................................................................30
RESULTS ......................................................................................................................................31
PARTICIPANT CHARACTERISTICS................................................................................................31
PARENTING DESIRES .................................................................................................................31
MECHANISMS ............................................................................................................................35
BARRIERS AND FACILITATORS....................................................................................................39
DISCUSSION .................................................................................................................................52
LIMITATIONS ...............................................................................................................................54
CONCLUSIONS .............................................................................................................................55
Table 1: Participant Demographics........................................................................................56
CHAPTER 4: RECOMMENDATIONS....................................................................... 57
REFERENCES................................................................................................................ 62
APPENDIX 1: IN-DEPTH INTERVIEW GUIDE ...................................................... 67
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