"I did not know about all these": Perceptions regarding safer conception methods by women living with HIV in Gaborone, Botswana

• Published in: PloS one 2020-12, Vol.15 (12), p.e0242992
• Main Authors: Gutin, Sarah A, Harper, Gary W, Moshashane, Neo, Ramontshonyana, Kehumile, Mompe, Atlang, Fleming, Paul J, Harries, Jane, Ramogola-Masire, Doreen, Morroni, Chelsea
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Biology and Life Sciences; Botswana; Circumcision, Male; Coitus; Conception (Human reproduction); Couples; Data collection; Disease transmission; Female; Fertility; Fertilization; Focus Groups; Health aspects; Health behavior; Health education; Health Knowledge, Attitudes, Practice; Health literacy; Health Promotion; Health risks; Health sciences; HIV; HIV Infections - prevention & control; HIV Infections - psychology; HIV Infections - transmission; HIV patients; Human immunodeficiency virus; Humans; Insemination, Artificial; Medical research; Medicine; Medicine and Health Sciences; Methods; Middle Aged; People and Places; Perception; Perceptions; Phenomenology; Policies; Pre-Exposure Prophylaxis; Pregnancy; Prophylaxis; Public health; Public sector; R&D; Research & development; Safety; Social Sciences; Social Stigma; Support groups; Surveys; Vagina; Women patients; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0242992

Various safer conception methods to limit HIV transmission risks can be offered in resource-constrained settings. However, implementation of safer conception services remains limited in many countries, including Botswana. Understanding perceptions about safer conception methods and the benefits and challenges to use can help with the development of policies, interventions, and service delivery models. Forty-five women living with HIV in the greater Gaborone, Botswana area participated in focus group discussions. Themes were analyzed using interpretive phenomenology. Despite low knowledge of specific safer conception methods that can be used to prevent transmission of HIV when trying to achieve pregnancy, there was noted interest in pre-exposure prophylaxis and vaginal insemination. Challenges to greater uptake were noted including a lack of knowledge about a range of SC methods, limited partner support and communication, provider stigma, health systems barriers, current policies, and the cultural acceptability of methods. Interventions will need to address these challenges and be responsive to the needs and reflect the realities of WLHIV who desire pregnancy in order for safer conception uptake to become a common practice.