Reproductive health and HIV contraception and the prevention of HIV infection-Conception and contraception in Thai people living with HIV : Report of project results

Abstract

Abstract Objective: To assess sex practices, contraceptive methods used and the intention for conception in Thai heterosexual HIV-positive women and men, who are either married or in a stable relationship. Methods: We applied a mixed research method, by gathering quantitative data, via administering a questionnaire, and qualitative data, via conducting focus group discussions (FGD). 200 HIV-positive men and women at HIV-NAT clinic and Anonymous Clinic in Bangkok, completed a self-administered questionnaire. Eleven female participants took part in two FGD, based on their intention for conception. Statistical analysis: We used descriptive statistics to present the results from the questionnaire. To assess association between two variables of interest we applied logistic regression or Chi-square exact test. We used a narrative approach to present the results from the FGD. Results: The median age of the participants was 37 years, and they were living for a median of 8.5 years with HIV. Almost all participants were sexually active and almost all were on successful antiretroviral therapy. The most cornmon choice of contraception for women was the male condom, followed by female sterilization (40%). Half of them reported the use of dual contraception. Almost all rnen reported consistent condom use. Most of the participants had sex with their main partner, of whom one-third were HIV-negative. One-fifth of men had sexual relationship with an occasional partner. The intention for conception was significantly less after being diagnosed with HIV. Nevertheless, 25% of the participants expressed a desire to have a child. There was a significant association between the intention for conception and the fewer years of being married and the lower number of living children. Men and women with higher levels of education tended to have a stronger desire for a child. Discussion: Thai men and women with stable HIV and married or in a stable relationship are sexually active and tend to practise safe sex. Many desire to have children. Therefore, there is a need to provide comprehensive reproductive health care services to this group of people. HIV-positive rnen and women, who want to have children, should be supported and counseled regarding safe ways to conceive. For those who do not want to have children, there is a substantial choice of contraceptive methods.