Pregnancy Decisions of Women Living with HIV: The Need for Multidisciplinary Perspectives

February 2013 - Structural Prevention

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Gruskin, S. Reproductive Health Matters (December 2012), Editorial, Vol. 20 No. 39S, pp. 1-4

The author of this editorial presents an overview of articles that offer multidisciplinary perspectives on aspects of pregnancy decisions for HIV-positive women. There are concerns about the direction of policy of the global response to HIV and pregnancy. Recently, limited evidence regarding whether injectable hormonal contraception increases HIV risk has made policy decisions challenging. Postnatal services, in addition to abortion services and policies, are lacking, and reproductive health services are generally inadequate for HIV-serodiscordant couples. Yet, while more programs are available for HIV-positive women, health services need to offer quality support and respond to all reproductive health needs in a stigma and discrimination-free setting, because stigma limits women's access to care and may influence reproductive health decisions. Essential health services are associated not only with prevention of mother-to-child transmission, but also improved maternal health. The collection of articles also included a proposed framework for designing and implementing integrated services that identifies influences on reproductive decision making by serodiscordant couples. A study from the Asia-Pacific region was included that identified issues women encounter when accessing reproductive health services. The author urges researchers and program planners to use the evidence presented to drive multidisciplinary research studies, policies, and program design and implementation for reproductive health.

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