The Pregnancy Decisions of HIV-Positive Women: The State of Knowledge and Way Forward

23 Pages Posted: 15 Feb 2014 Last revised: 25 Mar 2014

See all articles by Sarah MacCarthy

Sarah MacCarthy

Warren Alpert Medical School

Jennifer Rasanathan

Montefiore Medical Center

Laura Ferguson

Harvard School of Public Health

Sofia Gruskin

University of Southern California Institute on Inequalities in Global Health; University of Southern California Keck School of Medicine; University of Southern California Gould School of Law

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Date Written: 2012

Abstract

Despite the growing number of women living with and affected by HIV, there is still insufficient attention to their pregnancy-related needs, rights, decisions and desires in research, policy and programs. We carried out a review of the literature to ascertain the current state of knowledge and highlight areas requiring further attention. We found that contraceptive options for pregnancy prevention by HIV-positive women are insufficient: condoms are not always available or acceptable, and other options are limited by affordability, availability or efficacy. Further, coerced sterilization of women living with HIV is widely reported. Information gaps persist in relation to effectiveness, safety and best practices regarding assisted reproductive technologies. Attention to neonatal outcomes generally outweighs attention to the health of women before, during and after pregnancy. Access to safe abortion and post-abortion care services, which are critical to women’s ability to fulfill their sexual and reproductive rights, are often curtailed. There is inadequate attention to HIV-positive sex workers, injecting drug users and adolescents. The many challenges that women living with HIV encounter in their interactions with sexual and reproductive health services shape their pregnancy decisions. It is critical that HIV-positive women be more involved in the design and implementation of research, policies and programs related to their pregnancy-related needs and rights.

Keywords: HIV, AIDS, sexual health, reproductive health, human rights

Suggested Citation

MacCarthy, Sarah and Rasanathan, Jennifer and Ferguson, Laura and Gruskin, Sofia, The Pregnancy Decisions of HIV-Positive Women: The State of Knowledge and Way Forward (2012). Reproductive Health Matters, Vol. 20, Supp. 39, pp.119-40, 2012, USC CLASS Research Paper No. CLASS14-5, Available at SSRN: https://ssrn.com/abstract=2395537

Sarah MacCarthy (Contact Author)

Warren Alpert Medical School ( email )

Providence, RI 02912
United States

Jennifer Rasanathan

Montefiore Medical Center ( email )

111 East 210th Street
Bronx, NY 10467
United States

Laura Ferguson

Harvard School of Public Health ( email )

677 Huntington Avenue
Boston, MA MA 02115
United States

Sofia Gruskin

University of Southern California Institute on Inequalities in Global Health ( email )

2001 N. Soto Street
Los Angeles, CA 90032

HOME PAGE: http://globalhealth.usc.edu

University of Southern California Keck School of Medicine ( email )

2001 N. Soto Street
Los Angeles, CA 90032
United States

University of Southern California Gould School of Law ( email )

699 Exposition Boulevard
Los Angeles, CA 90089
United States

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