Within the last decade, clinical and pharmacological advances have resulted in excellent pregnancy outcomes for women living with HIV (WLHIV). The study of social factors influencing reproductive decision-making in WLHIV have not kept pace, however. Among the multiple factors identified as barriers and facilitators of reproductive decision-making among WLHIV inlcude partners, or significant Others (SO). The SO is acknowledged as an influential, possibly dominant, participant in reproductive decision-making.
To identify the role, impact, and perceptions of the SO in actively participating in the reproductive decision-making of WLHIV.
The subset of data regarding WLHIV was extracted from a larger systematic review regarding the reproductive decisions of WLHIV. Articles published from 1990 through 2016 were retrieved from eight databases searching with the keywords “pregnancy”, “reproductive”, “decision-making”, “HIV”, “AIDS”, “women”. Only articles originally published in English and conducted in the Organization for Economic Co-operation and Development (OECD) countries were included.
A total of nine studies were included for this review; all conducted in the United States, Canada and Australia with either a qualitative, quantitative or review designs. Mean age of participants: 33.76 years (SD=6.62). The SO and family were identified as the primary influence with impact for the reproductive decision-making process in WLHIV. To a lesser extent, society and group support appear as slightly influential, but the mechanisms were not clearly described in the literature. The WLHIV indicated the SO support ranged from postive and constructive to negagtive and destructive, with varied impact on the ultimate decision-making.
When caring for WLHIV, nurses need to identify the SO realizing this person will impact the reporoctive decision making process. Furthermore, nurses need to be prepared to engage both the WLHIV and the SO in converasations about reproductive decision-making, providing realistic strategies for a potential pregnancy. The WLHIV, and their SO, are often concerned about "giving" their virus to their baby during pregnancy. As such, nurses need to develop strategies to help WLHIV to make collaborative and well informed decisions with their SO, referencing the current and changing evidence. The goal is to bring the decision-making process from an individual conern in the background, to a group conern in the foreground.
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