Desire for Pregnancy, Contraception, and HIV Risk among Serodiscordant Couples

Columbia University Health Sciences, New York NY

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): In this revision application, we are proposing expanding the scope of our study, "Desire for Pregnancy, Contraception, and HIV Risk among Serodiscordant Couples" (HD058338) to include seroconcordant couples. The opportunities today are far better than 10-15 years ago for HIV+ individuals and couples to have an uninfected child and to survive long enough to raise it. These developments combined with the expectation for a more normal life due to the transformation of HIV into a chronic illness has strengthen the desire of many in this population to have a first or another child. However, there is a paucity of research on HIV+ heterosexual seroconcordant couples'and serodiscordant couples'reproductive and contraceptive preferences and practices that elicits data from both partners. The perspective of seropositive men on issues of reproductive and contraception and their impact on sexual behavior has been conspicuously absent especially in US-based research. A focus on the couple is particularly appropriate with regard to the issues under investigation as it is typically in the context of a stable relationship that individuals contemplate having a child and engage in unprotected sex as a means of communicating mutual trust and commitment. To address the gaps in the HIV literature, we are currently investigating the sexual, contraceptive and reproductive intensions and behaviors of 100 HIV+ serodiscordant heterosexual couples who have been in a sexual relationship for at least 6 months. We are also attempting to expand the Theory of Gender and Power by investigating whether serostatus is another dimension, in addition to gender, along which power is distributed in serodiscordant couples. To achieve these aims, we are conducting in-depth individual interviews with both partners of each couple and a dyadic interview with a subsample of these couples. In 50 of the couples, the male is the infected partner and in the other 50 the female is the infected partner. In this revision application, we are seeking additional funding will allow us to enhance the substantive and theoretical contributions of the parent study by adding a third group of 50 HIV+ seroconcordant couples to the sample, thus permitting a 3- rather than 2-group comparison. The study findings will have important implications for the design of programs to educate and support the full spectrum of heterosexual couples contending with HIV/AIDS, whatever their reproductive intensions and behaviors. PUBLIC HEALTH RELEVANCE: In this revision application, we are proposing expanding the scope of our study, "Desire for Pregnancy, Contraception, and HIV Risk among Serodiscordant Couples" (HD058338) to include seroconcordant couples. The opportunities today are far better than 10-15 years ago for HIV+ individuals and couples to have an uninfected child and to survive long enough to raise it. These developments combined with the expectation for a more normal life due to the transformation of HIV into a chronic illness has strengthen the desire of many in this population to have a first or another child. However, there is a paucity of research on HIV+ heterosexual seroconcordant couples'and serodiscordant couples'reproductive and contraceptive preferences and practices that elicits data from both partners. The perspective of seropositive men on issues of reproductive and contraception and their impact on sexual behavior has been conspicuously absent especially in US-based research. A focus on the couple is particularly appropriate with regard to the issues under investigation as it is typically in the context of a stable relationship that individuals contemplate having a child and engage in unprotected sex as a means of communicating mutual trust and commitment. The study findings will have important implications for the design of programs to educate and support the full spectrum of heterosexual couples contending with HIV/AIDS, whatever their reproductive intensions and behaviors.