Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

Reproductive Health

Joan E. Edwards¹  Sandra K. Cesario¹  Karen A. Dominguez-Cancino²  Juan M. Leyva-Moral³  Lidia Pardell-Dominguez³  Ariadna Huertas-Zurriaga⁴  Sergio Alonso-Fernandez⁵  Patrick A. Palmieri⁶ 

[1] Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, 77030, Houston, TX, USA;Nelda C. Stark College of Nursing, Texas Woman’s University, 6700 Fannin St, 77030, Houston, TX, USA;EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, 15023, Lima, Peru;Escuela de Enfermería, Universidad Científica del Sur, Carr. Panamericana Sur 19, Villa EL Salvador, 15067, Lima, Perú;Escuela de Salud Pública, Universidad de Chile, Independencia 939, Independencia, 8380453, Santiago de Chile, Chile;Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain;EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, 15023, Lima, Peru;Department D’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain;Hospital Universitari Germans Trias I Pujol, Badalona, 08916, Barcelona, Spain;Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain;Recerca i Innovació en Cures Infermeres, Hospital Universitari Germans Trias I Pujol, Badalona, 08916, Barcelona, Spain;South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Torre 2, Piso 4, 15046, Lima, Perú;College of Graduate Health Studies, A. T. Still University, 800 W. Jefferson Street, 63501, Kirksville, MO, USA;Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, 77030, Houston, TX, USA;EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, 15023, Lima, Peru;

关键词: AIDS;    HIV;    Decision-making;    Pregnancy;    Reproductive health;    Women;    SIDA;    VIH;    Toma de decisiones;    Embarazo;    Salud reproductiva;    Mujeres;   

DOI  :  10.1186/s12978-021-01197-6

来源: Springer

【 摘 要 】

BackgroundWomen living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries.MethodsA systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis.ResultsTwenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage.ConclusionWLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.

【 授权许可】

CC BY