Providers perspectives on preconception counseling and safer conception for HIV-infected women

Alison S. Coll, Jonell E. Potter, Nahida Chakhtoura, Maria L. Alcaide, Ryan Cook, Deborah L. Jones

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Introduction: Unplanned pregnancy among HIV-infected women can have negative health consequences for women, partners, and neonates. Despite recommendations, preconception counseling (PCC) appears to be infrequently addressed in HIV care. This study explored knowledge, attitudes, and practices among health-care providers regarding PCC, safer conception and pregnancy among HIV-infected women. Methods: Physicians, physician assistants, and nurse practitioners (n = 14) providing obstetric/gynecological and HIV care in urban south Florida public and private hospitals completed structured qualitative interviews. Dominant themes arising included provider perceptions of patient knowledge and practices, provider knowledge and attitudes regarding safer conception, and provider practices regarding reproductive health. Results: Providers perceived patients to have limited reproductive knowledge. Patients internalized HIV stigma was a barrier to patient initiation of conception-focused discussions. Provider knowledge and utilization of PCC protocols were limited. PCC barriers included competing medical priorities, failure to address fertility desires, limited knowledge, time limitations, and unclear standard of care. Providers routinely used condom-based HIV prevention as a proxy for addressing reproductive intentions. Discussion: Provider, patient, and structural factors prevented implementation of PCC and provision of information on safer conception; neither were routinely discussed during consultations. Both providers and patients may benefit from interventions to enhance communication on conception.

Original languageEnglish (US)
Pages (from-to)513-518
Number of pages6
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume28
Issue number4
DOIs
StatePublished - Apr 2 2016

Keywords

  • HIV
  • Preconception counseling
  • qualitative
  • safer conception methods
  • unplanned pregnancy

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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