Factors Influencing Pregnancy Decision Making among Known HIV Positive
Women of Reproductive Age in Busia County, Western Kenya
Hudson Inyangala
1*
, Judith A Makwali
2
and Sylvia O Aluku
3
1
Jhpiego Corporation, Nairobi, Kenya - An Affiliate of Johns Hopkins University, Kenya
2
University of Eldoret, Department of Biological Sciences, Kenya
3
Ministry of Health, Busia County, Kenya
*
Corresponding author: Hudson Inyangala, Jhpiego Corporation, Nairobi, Kenya - An Affiliate of Johns Hopkins University, Kenya, Tel: 254721727398; E-mail:
hudson.inyangala@jhpiego.org
Received date: September 06, 2016; Accepted date: September 16, 2016; Published date: September 30, 2016
Copyright: © 2016 Inyangala H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Kenya is one of the six HIV ‘high burden’ countries in Africa with about 1.6 million people living with
HIV infection by 2013. Women in Kenya are more vulnerable to HIV infection compared to men, with the national
HIV prevalence at 7.6% for women and 5.6% for men. There were about 1441 pregnant women living with HIV in
Busia County in 2013, with an estimated 57 new paediatric infections. HIV positive mothers, have a constitutional;
human right and may want to have children but the timing has to be right to minimize the chances of transmission.
Aim: To establish the factors that influence pregnancy decision making amongst known HIV positive women of
reproductive age in Busia County, Western Kenya.
Methods: Desk review of existing PMTCT data in DHIS2, structured focused group discussions (FGDs) and
health facility questionnaire based cross-sectional survey among known HIV positive pregnant women of
reproductive age, and those with infants aged below 6 months attending antenatal (ANC)/PMTCT and child welfare
clinics (CWC) were used.
Results: Among the 128 women interviewed, 98 (77%) knew their HIV positive status prior to becoming
pregnant, while 17 (13%) discovered their status at first ANC, 8 (6%) at labour and delivery and 5 (4%) at 2 weeks
post-partum. Overall, the women shared similarities in their socio-demographic profile. Over 60% of the respondents
were cognizant of the risk involved in getting pregnant. Regardless of women’s pregnancy experiences or intentions,
considerations in pregnancy decision-making was based on desire for motherhood; religious values; stigma;
attitudes of partners and health care providers.
Conclusion: The younger HIV positive women, with 1 or 2 children were three times more likely to get pregnant
than older ones (OR=2.67) despite their HIV positive status and the risks involved to fulfil societal concerns.
Keywords: Known HIV positive; Pregnancy
Abbreviations: KP: Known Positive; PMTCT: Prevention of Mother
to Child Transmission of HIV; EMTCT: Elimination of Mother to
Child Transmission; MTCT Rate: Mother to Child Transmission Rate
Introduction
Globally there are 40,385 new HIV infections weekly. Over 4,600
babies and 7,000 young women are infected each week [1]. In sub-
Saharan Africa, women of childbearing age comprise 61% of people
living with HIV, accounting for over 12 million women [2]. In Kenya,
HIV incidence is increasing most dramatically among young women
aged 18 to 30 years [3], which coincides with their peak reproductive
years. Kenya has committed to eliminating new HIV infections among
children by 2015, while keeping their mothers alive. is commitment
is not on track.
Women of reproductive age are disproportionately affected by the
HIV/AIDS epidemic, with women accounting for nearly 60% of people
living with HIV in Busia County. e decision to get pregnant can be
complex regardless of HIV sero-positivity, among HIV-infected
women, however, getting pregnant introduces additional personal,
public health, and clinical care concerns that must be addressed [4].
e vast majority of conceptions are unplanned and occur without the
use of reproductive technologies such as sperm washing and artificial
insemination. us, the unprotected sexual activity required for
conception carries a significant risk of HIV transmission to uninfected
sexual partner and the unborn child. Pregnancy among HIV positive
women also carries a significant risk of vertical transmission during
pregnancy, labour and delivery and post-natally through breastfeeding
[4]. It is in view of these considerations that reproductive counselling
sessions by most health care workers for people living with HIV, have
largely been dissuasive, and HIV positive women who express a desire
to have children continue to encounter the disapproval of health care
workers. Although the potential negative health of the known HIV
positive woman may have dampened the fertility intensions of known
HIV positive women, the stigma associated with childlessness in the
traditional African setting, the strong personal desire for biological
parenthood remain potent drivers of the desire to get pregnant, despite
Inyangala et al., J Preg Child Health 2016, 3:5
DOI: 10.4172/2376-127X.1000281
Research Article OMICS International
J Preg Child Health, an open access journal
ISSN:2376-127X
Volume 3 • Issue 5 • 1000281
Journal of Pregnancy and Child Health
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ISSN: 2376-127X