Factors Associated with safer conception uptake by women living with HIV in Botswana

Small Fund Research Project
Sarah Gutin

Botswana has one of the highest HIV rates in the world and sentinel surveillance data shows that 30.4% of women of reproductive age (aged 15 to 49) are living with HIV. However, HIV infection reduces but does not eliminate the desire for children. While interventions to
prevent mother-to-child transmission have been very successful safer conception (SC) strategies, which protect partners from HIV infection during conception, are underutilized. Current SC interventions assume that women living with HIV (WLHIV) plan their pregnancies and will actively seek advice and care from healthcare providers when they desire childbearing. However, these assumptions may not be correct in HIV-endemic countries, such as Botswana. There may be many reasons why WLHIV do not seek SC services including a lack of pregnancy planning, stigma, or limited knowledge of SC. Yet Botswana Ministry of Health (MOH) policies do not target SC for WLHIV. This is a missed opportunity to prevent HIV transmissions, especially since the bulk of new HIV infections in Botswana occur among heterosexual partners. Given the desire by the MOH to prevent new HIV infections, this research study will employ multiple methods to explore pregnancy planning, stigma, and the factors that influence whether WLHIV access SC strategies and services. Qualitative focus group discussions will be used to explore the cultural construction of planned pregnancy and whether stigma affects PLHIV's reporting of fertility desires and intentions to utilize SC strategies. In addition, a quantitative survey will be used to assess the factors that influence whether WLHIV access SC strategies and services. These approaches are expected to reveal specific local and cultural nuances. This research will take place over one year in and around Gaborone, the capitol of Botswana. This study would allow me to gather data in Botswana to complete the final two chapters of my dissertation. This research offers an important opportunity to develop targeted interventions focused on preventing new HIV infections in Botswana and similar countries.

Eva L. Mueller New Directions in Economics and Demography Fund

Funding Period: 10/1/2017 to 09/30/2018

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