AIDS and Behavior

, Volume 13, Supplement 1, pp 47–54 | Cite as

A Qualitative Assessment of Decisions Affecting Contraceptive Utilization and Fertility Intentions among HIV-Positive Women in Soweto, South Africa

  • Fatima Laher
  • Catherine S. Todd
  • Mark A. Stibich
  • Rebecca Phofa
  • Xoliswa Behane
  • Lerato Mohapi
  • Glenda Gray
Original Paper


The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women.


Contraception Fertility intentions HIV HAART Qualitative methods 



This study was supported by the Morris S. Smith Foundation and the Doris Duke Charitable Trust. We acknowledge USAID/PEPFAR. We thank participants for their time and trust.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Fatima Laher
    • 1
  • Catherine S. Todd
    • 2
  • Mark A. Stibich
    • 3
  • Rebecca Phofa
    • 1
  • Xoliswa Behane
    • 1
  • Lerato Mohapi
    • 1
  • Glenda Gray
    • 1
  1. 1.Perinatal HIV Research UnitUniversity of the WitwatersrandJohannesburg, SowetoSouth Africa
  2. 2.Department of Obstetrics and GynaecologyColumbia UniversityNew YorkUSA
  3. 3.Division of International Health and Cross-Cultural MedicineUniversity of CaliforniaSan Diego, La JollaUSA

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