The increased access to
effective antiretroviral treatment (ART) has made HIV comparable to a chronic
disease in terms of life expectancy. Needs related to sexuality and
reproduction are central to overall health and well-being. An interpretative
meta-synthesis was performed to synthesize and assess how HIV-positive women's
experiences of sexuality and reproduction have been described in qualitative
studies. A total of 18 peer-reviewed qualitative studies were included, which comprised
a total of 588 HIV-positive interviewed women. The studies originated from
resource-rich countries outside the Asian and African continents. The analysis,
resulting in a lines-of-argument synthesis, shows that HIV infection was a
burden in relation to sexuality and reproduction. The weight of the burden
could be heavier or lighter. Conditions making the HIV burden heavier were: HIV
as a barrier, feelings of fear and loss, whereas motherhood, spiritual beliefs,
and supportive relationships made the HIV burden lighter. The findings are
important in developing optimal health care by addressing conditions making the
burden of HIV infection lighter to bear. In future research there is a need to
focus not only on examining how HIV-positive women's sexual and relationships
manifest themselves, but also on how health care professionals should provide
adequate support to the women in relation to sexuality and reproduction.
...Ah, it's just
always in the bedroom, HIV. It's always there33, p.7
...In holistic care, it is important for health care
professionals to see the women as whole individuals and not only focus on the
disease. The result emphasizes the strength of support from health care
professionals. But support is not only offering information; support is also
about listening. There were narratives in the included studies of experiences
of violence, which the women might need help to handle. As health care
professionals, we have to ask and be open to stories of, for example, rape, or
abuse. Supporting self-acceptance and awareness are only a few of the many
areas where care providers outside the medical context can be important for
patients' ongoing well-being.8 The
importance of support from other HIV-positive women is emphasized in the
meta-synthesis.20,22,30,34,36 Even
though it is difficult for some women to attend support meetings like this, as
it means they have to disclose their HIV-positive status, it is important to
motivate women to meet other HIV-positive persons.
...There is a need for practical information about
contraceptives, medical risks, and interventions related to the risk of HIV
transmission and barriers between fertility intentions, and pregnancy seeking
behavior also need to be illuminated.65 Women
actively trying to conceive intend not to talk with their provider about safer
conception strategies and they expressed confusion and concern on how to
conceive safely.66 Reproductive
counseling initiated by health care providers is needed to reduce risk of
transmission to partners and infants, which can have major health implications.66
Disclosure of HIV-positive status seems
problematic, and some women may need the presence of a health care professional
when the disclosure is made.67 Everything
has to be done without judgment; it is important for health care professionals
not to relate to their personal sexual behaviors as the sexual norm.
In clinical practice, it might be of importance to
address all these conditions that make the burden easier, to support pregnancy,
to support the desires of these women, and to help them cope with negative
feelings, in order to promote the sexual and reproductive health of
HIV-positive women.
Full article at: http://goo.gl/ZjBwDF
By: Ewa Carlsson-Lalloo, RN, MHCSci,*1,,2 Marie Rusner, RN, MSc, PhD,1,,3 Åsa Mellgren, MD, PhD,2,,3 and Marie Berg, RN, RM, MNSci, MPH, PhD1,,4
1Institute of Health and Care Sciences,
Sahlgrenska Academy, Gothenburg, Sweden.
2Clinic of Infectious Diseases, Södra
Älvsborg Hospital, Borås, Sweden.
3Department of Research, Södra Älvsborg
Hospital, Borås, Sweden.
4Centre for Person-Centred Care (GPCC),
University of Gothenburg, Gothenburg, Sweden.
*Corresponding
author.
Address
correspondence to:, Ms. Ewa Carlsson-Lalloo, Institute of Health and
Care Sciences, Box 457, University of Gothenburg, 405 30 Gothenburg,
Sweden,
E-mail: es.ug@oollal.nosslrac.awe
E-mail: es.ug@oollal.nosslrac.awe
More at: https://twitter.com/hiv insight
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