Contraceptive use among HIV-positive women in Quang Ninh province, Vietnam.

OBJECTIVE: To investigate contraceptive use among HIV-positive women in Ha long city and Cam Pha town of Quang Ninh, a Northern province of Vietnam. METHODS: Cross-sectional questionnaire study among HIV-positive women identified through the district HIV/AIDS register. Information on socioeconomic characteristics and contraceptive use before and after HIV diagnosis was obtained through structured questionnaires. Chi-square testing was used to assess whether the included women differed from the target population in terms of age. Crude Odds ratios (ORs) were calculated to show the association between contraceptive use and the women's socioeconomic characteristics. Logistic regression analyses were applied to adjust for possible confounding. The women's contraceptive use before HIV testing and after HIV testing was described and compared by Chi-square testing, and the association between post-test counselling and the women's use of condom was assessed by ORs. RESULTS: Of the 351 participants, 63% stated they had used contraception before HIV diagnosis and 89% stated they had used contraception after HIV diagnosis. Forty six per cent of the women had been using either the pill or an intrauterine device (IUD) before the diagnosis whereas the same applied for only 8% of the women after diagnosis. Thirty-nine per cent stated they had been using condom before HIV diagnosis whereas 87% stated condom use after HIV diagnosis. Condom use was more common among women who had received post-test counselling (OR 3.03, 95% CI 1.03-8.90). CONCLUSIONS: A change of contraceptive methods from IUD and oral contraception before HIV diagnosis to condom use after HIV diagnosis was observed. The women's use of condoms after HIV diagnosis was associated with having received post-test counselling.

Prevention of mother-to-child transmission--precarious hopes and childbearing choices among HIV-infected women in a northern province of Vietnam.

The world over, increased access to treatment brings reproductive hope to women infected with HIV. Yet, despite the expanding availability of programs for prevention of mother-to-child transmission, HIV-positive women continue to face numerous problems and uncertainties in the realm of reproduction. The results reported here are derived from ethnographic research conducted in a northern province of Vietnam in 2007. The authors interviewed 32 HIV-positive women, exploring the hopes that they invested in prevention of mother-to-child transmission, and examining how this new technology enhanced the women's faith in their futures and childbearing capacities. Based on the findings, the authors discuss the new forms of gendered uncertainty that arise in the era of HIV/AIDS in Vietnam. They conclude that prevention of mother-to-child transmission, including the counseling offered by health providers, plays an important role in building and strengthening reproductive hopes for women living with HIV, while also generating new concerns.

Pregnancy decision-making among HIV positive women in Northern Vietnam: reconsidering reproductive choice.

The global HIV epidemic confronts pregnant women with hard reproductive choices. This paper offers a theoretically innovative and ethnographically sensitive exploration of the social processes through which 20 HIV positive women living in Northern Vietnam decide whether to continue or terminate their pregnancies. Arguing that human agency must be seen as an outcome of intersubjective engagements in shared social worlds, this paper explores how these women came to the decisions that they had to make and shows that women's choices were configured through everyday social relations, shaped through intimate engagements with husbands, parents, siblings, and in-laws. Based on the findings, it is recommended that pregnancy counseling is offered not only to the woman herself, but also, if she desires, involves members of her extended family.

Induced abortion among HIV-positive women in Northern Vietnam: exploring reproductive dilemmas.

Across the world, childbearing among HIV-positive women is a socially controversial issue. This paper derives from a larger research project that investigated reproductive decisions among HIV-positive women in Quang Ninh, a northern province of Vietnam. The paper focuses on 13 women who had an abortion after being diagnosed as HIV-positive, exploring their reflections, concerns and dilemmas. The results show that the HIV-positive pregnant women sought to balance their desires for a child with their worries of being unable to fulfill their responsibilities as mothers. Even while strongly desiring to become mothers, women in this study opted to terminate their pregnancies out of fear that they could not care adequately for the child they expected. These results indicate that when providing reproductive health counselling and support for HIV-positive women and their families, it is essential to take into account the socio-cultural factors that shape women's reproductive options.

Posttest counseling and social support from health staff caring for HIV-infected pregnant women in Vietnam.

Women with HIV who want to have children face a range of challenges, quandaries, and hard decisions. This article examines the role of health staff in supporting HIV-infected pregnant women who desire to maintain their pregnancies. The article is derived from anthropological research conducted in Vietnam's Quang Ninh Province, an area that has a high HIV prevalence rate and is covered under the government's prevention of mother-to-child transmission program. The study included in-depth interviews with 23 HIV-infected women who had either recently given birth or were pregnant at the time of the research. Results showed that women were satisfied with the services they received from the program. The women believed that health care staff offered them not only medical care but also social and emotional support. The article concludes that the health care system is a vital point of support for pregnant women with HIV.