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Conception Practices of HIV-Infected Women in the Midwest

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The aim of this interpretive study was to understand pregnancy intentions and conception practices of HIV-infected women. A purposive sample of 3 White and 12 African American women who were interested in becoming mothers was recruited from a hospital clinic and a private practice in the Midwest. Participants were interviewed three times at monthly intervals. Data were analyzed using interpretive methods. Three conception practices were identified: (a) a technical method using self-insemination, (b) a minimize-risk approach based on use of highly active antiretroviral therapy, and (c) a default approach in which no plan for conception was evident. Although all of the women reported that they had talked with their health care providers about conception, most did not have adequate information to make an informed choice. Nurses play a critical role in shaping conception decisions by providing accurate, understandable information about conception practices specific to a woman's social realities and cultural values.

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Methods

Interpretive phenomenology was the methodology used for this study. This approach seeks to capture everyday practical activities and is based on lived human involvement in the world (Benner, 1994). Interpretive phenomenology takes into account the context and background meanings that flow from history, culture, and family traditions, and thus was appropriate for the purposes of the study. Purposive sampling techniques were used to identify 15 women who were not currently pregnant and had some

Description of Sample

The sample was composed of 12 African American and 3 White women between the ages of 21 and 38. A total of 8 women were currently partnered in heterosexual relationships. Of these, only 1 woman was in a relationship with a partner who was also HIV-infected. Of the 7 women who were not currently in relationships, all were open to the possibility that a future partner might or might not be HIV-infected. Table 1 contains additional demographic information.

Identification of Conception Practices

Thematic analysis of the data, an in-depth

Discussion

The results of this study show that HIV-infected women intending to have a child are exploring a variety of ways to conceive. Although all women in this study reported that they had talked with or intended to talk with their health care provider about getting pregnant, most had inadequate information about conception practices and occasionally were misinformed. For example, one woman understood that self-insemination would protect her partner but also thought that if she used self-insemination,

Implications for Practice

Nurses can and should help to shape conception decisions of HIV-infected women. Women with HIV do not make their decision to have a child casually (Sandelowski & Barroso, 2003). Reproductive decisions are much more stressful and complex in the context of any chronic illness, especially HIV. Nurses need to assess what conception plans a woman might or might not have and gain knowledge of her specific situation so that appropriate assistance can be offered. This requires a caring relationship in

Conclusion

This interpretive study with 15 participants revealed three conception practices adopted by HIV-infected women who strongly desired to have a child: self-insemination, minimizing of risk to one's partner by using antiretroviral therapy and timed intercourse, and a default approach. The majority of the women in this study did not have a plan for achieving pregnancy while protecting a partner from HIV infection, although all expressed concern about partner safety. Because men strongly influence

Nancy J. Cibulka, PhD, APRN, BC, is an associate professor, Maryville University and Barnes-Jewish Hospital, Saint Louis, Missouri.

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    Nancy J. Cibulka, PhD, APRN, BC, is an associate professor, Maryville University and Barnes-Jewish Hospital, Saint Louis, Missouri.

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    Copyright © 2007 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.