Over 60% of those living with HIV/AIDS are women, the majority of them in their sexual and reproductive years (UNAIDS, 2006). With antiretroviral (ARV) drugs, most of them are living longer and healthier to engage in sexual and reproductive activities (WHO, 2006). This study explored the sexual and reproductive decisions and experiences of women living with HIV/AIDS (WLWHA) in Abuja, Nigeria. Only those who became pregnant and had a child after being diagnosed with HIV participated in the study. The study was an interview based qualitative research. The design of the interview guide was informed by the PEN-3 Model (Airhihenbuwa, 1995). A combination of purposive and snowball sampling technique was used to select 17 WLWHA aged between 26 and 41. Most of them had limited education, only the 3 of them with post secondary education had professional jobs; the rest are either housewives or petty traders. Most of the women had reduced sexual desire but felt compelled to acquiesce to their husband’s sexual demands out of cultural and religious sense of duty, fear that he would have sex outside marriage and/or beat them. While a few used condoms, most either did not use condom or used it inconsistently. Condoms were used mainly to prevent re-infection with another strain of HIV or to prevent infecting a negative partner. Reason for non use of condom includes reduced sexual pleasure with condoms, belief that condoms are used not for wives and that being on ARV precludes the need to use condom. Often, condom negotiation leads to violence. Most of the women still wanted more children and did not use contraceptives. Among the few who used contraceptives, condoms, hormone injections, intrauterine device (IUD) and tubal ligation are their methods of choice. The women chose to have babies to secure their marriage, fulfill maternal instinct and to “leave something behind”. Their decisions were informed by the belief that ARV would keep them alive, while Prevention of Mother to Child Transmission (PMCTC) programs would prevent infection to their babies. To conceive, they had unprotected sex during ovulation. Two serodiscordant couples used syringes to inseminate. Most of them had experienced obstetric challenges including infertility, miscarriages, preterm births, and infant deaths. Most of the women bottle-fed to prevent infecting their babies, however they were under tremendous pressure to breastfeed due to the cultural value attached to breastfeeding. Women living with HIV/AIDS in Abuja Nigeria, had unmet sexual and reproductive health needs. Their sexual and reproductive decisions were influenced by their individual circumstances, including their level of education, poverty, cultural and family influences, partner’s HIV status, stigma and discrimination, and access to PMTCT and ARV programs. To meet the sexual and reproductive health needs of WLWHA, program planners and policy makers should take these factors into consideration and ensure that programs are comprehensive and integrated.

<p>This study focuses on socio-cultural issues, which affect Kavango women&rsquo / s decision to participate in the PMTCT programme. It investigates the treatment methods used by HIV-positive pregnant women for themselves and their unborn babies, neonatally, during pregnancy and after delivery, particularly in relation to the prevention of transmission of HIV. The thesis further investigates whether women choose alternative services such as traditional healers for medical attention during pregnancy, birth and post-natally. The research aims to establish and describe the role of local notions and practices concerning anti-retrovirals on the aforementioned programme. Ethnographic and thus qualitative research methods were used to gather and analyze data. I spent three months working as a nurse in two health facilities that offer PMTCT in Rundu, Kavango. I also held semi-structured and open-ended interviews, formal and informal discussions, formal and informal focus groups with nurses, community counselors, pregnant women, women who had recently given birth in the health care facility and traditional health care practitioners. In the case of the latter, I utilized narratives of healing to understand their perception of HIV/AIDS, their beliefs and practices as well as their healing methods. Furthermore, I employed other informal conversations outside the formal research participants. The study shows that there is a paucity of partner involvement and in some cases women have to first seek permission from their partner before enrolling into the programme. My research findings further indicate that women utilized various traditional herbal medicines for themselves and their babies as part of their cultural beliefs and practices. It was evident that some of these, such as Likuki, affect women&rsquo / s participation in and adherence to the protocols of the PMTCT programme. </p>

<p>This study focuses on socio-cultural issues, which affect Kavango women&rsquo / s decision to participate in the PMTCT programme. It investigates the treatment methods used by HIV-positive pregnant women for themselves and their unborn babies, neonatally, during pregnancy and after delivery, particularly in relation to the prevention of transmission of HIV. The thesis further investigates whether women choose alternative services such as traditional healers for medical attention during pregnancy, birth and post-natally. The research aims to establish and describe the role of local notions and practices concerning anti-retrovirals on the aforementioned programme. Ethnographic and thus qualitative research methods were used to gather and analyze data. I spent three months working as a nurse in two health facilities that offer PMTCT in Rundu, Kavango. I also held semi-structured and open-ended interviews, formal and informal discussions, formal and informal focus groups with nurses, community counselors, pregnant women, women who had recently given birth in the health care facility and traditional health care practitioners. In the case of the latter, I utilized narratives of healing to understand their perception of HIV/AIDS, their beliefs and practices as well as their healing methods. Furthermore, I employed other informal conversations outside the formal research participants. The study shows that there is a paucity of partner involvement and in some cases women have to first seek permission from their partner before enrolling into the programme. My research findings further indicate that women utilized various traditional herbal medicines for themselves and their babies as part of their cultural beliefs and practices. It was evident that some of these, such as Likuki, affect women&rsquo / s participation in and adherence to the protocols of the PMTCT programme. </p>

Student Number: 0501772G - MA research report - School of Social Sciences - Faculty of Humanities / Development Communication theories suggest that media plays a critical role in the transformation of societies (Melkote, 2003). In line with this thesis, this research discusses the extent to which news media can provide a platform for social change for women’s health issues for the development of South Africa, in the context of the prevention of mother-to-child transmission of HIV (PMTCT). With approximately 29.5% of women attending antenatal clinics throughout the country being HIV-positive, PMTCT is one issue that demonstrates the socio-economic and political complexities of women’s health in the context of development. The qualitative methodological approach involves a thematic content analysis of the news media’s coverage around issues of PMTCT between July 1, 2004 and July 1, 2-005 in two South African newspapers The Star and The Mail and Guardian. The methods also involve a thematisation of interview responses from various stakeholders within news media and the case of PMTCT in South Africa. Empirical studies associate women’s access to media with better health and fertility outcomes, irrespective of various income and education levels (“Ch. 10: The Media”, 2002). This research report explores the extent to which a commercially driven news media can be for development; particularly for HIV-positive pregnant women can voice their perspectives and make empowered decisions for their health.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-04-27T16:06:36Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação completa NOVO.pdf: 1536561 bytes, checksum: 66148935591022f06fd7a82dc088abee (MD5) / Made available in DSpace on 2017-04-27T16:06:36Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação completa NOVO.pdf: 1536561 bytes, checksum: 66148935591022f06fd7a82dc088abee (MD5) Previous issue date: 2016-05-31 / As políticas sociais para enfrentamento da crescente epidemia de Aids desde o início da década de 1980 foram centradas no controle epidemiológico e na prevenção. No entanto, uma série de contradições na implementação e eficácia dessas políticas vêm sendo observadas por diversos pesquisadores e especialistas. Tem sido notório o crescimento da epidemia entre as mulheres. Tal problemática tem evidenciado uma série de questões relacionadas à saúde da mulher vivendo com HIV/Aids, dentre elas as relativas à sexualidade e reprodução. O objetivo principal desta dissertação foi analisar a lógica das estratégias, seu significado e práticas em saúde relacionadas ao acesso de mulheres soropositivas aos direitos reprodutivos e direitos sexuais em paralelo faz-se necessário também analisar as possíveis formas abertas e veladas de negação dos direitos sexuais e reprodutivos das mulheres vivendo com HIV/Aids e quais as estratégias adotadas pelo serviço de referência para que elas exerçam o direito de escolha da maternidade de maneira saudável, sem riscos de reinfecção, infecção do parceiro ou do feto. Esta pesquisa possibilitou aprofundar e apreender o debate acerca das contradições e conflitos presentes em nosso problema de pesquisa e está fundamentada na Teoria Social Crítica. Como procedimentos metodológicos fizemos uso de: análise documental; revisão bibliográfica; entrevista semi estruturada e grupo focal. Consideramos que mesmo com os avanços obtidos com a elaboração da Política Nacional de DST/Aids, no que se refere à saúde das mulheres, percebe-se objetivamente uma série de contradições na sua efetivação, pois o tratamento antirretroviral por si só não resolve a gama de problemas oriundos da infecção. Além da garantia de antirretroviral, se faz necessário o acesso a medicamentos para doenças oportunistas, a ampliação do acesso a especialistas. Nas entrevistas com os profissionais do serviço de referência identificamos por parte da maioria o desconhecimento em relação aos direitos reprodutivos e sexuais, falta de articulação e planejamento sobre esses direitos, e que atuação sobre essa temática é caracterizada por práticas individualizadas, embora ocorra a preocupação em orientar as mulheres sobre métodos contraceptivos e de reprodução. Uma dificuldade importante apontada por esses profissionais foi a alta demanda de atendimentos em relação ao número de profissionais; reflexo da atual situação r o uso de preservativo com seus parceiros. Acreditamos que ignorar/negar os direitos reprodutivos e direitos sexuais de mulheres vivendo com HIV/Aids não faz com que eles desapareçam, pelo contrário, não possibilita a sua reflexão, desfavorecendo o debate sobre o assunto e dificultando o poder de negociação das mulheres no uso de preservativo. / Social policies to confront the growing AIDS epidemic since the 1980s were centered on epidemic control and prevention. However, a number of contradictions in the implementation and efficacy of these policies have been observed by many investigators and experts. It has been noticeable growth of the epidemic among women. This issue has highlighted a number of questions related to women's health living with HIV / AIDS, among them those related to sexuality and reproduction. The main objective of this thesis was to analyze the logic of strategies, its meaning and health practices related to access of HIV-positive women to reproductive and sexual rights, in parallel it is necessary to also analyze the possible open and veiled forms of denial of sexual and reproductive rights of women living with HIV / AIDS and what are the strategies adopted by the referral service so that they exercise their right to choose the healthy way maternity, without the risk of reinfection, infection of the partner or of the fetus. This research allowed deepening and grasping the debate about the contradictions and conflicts present in our research problem from theoretical discussions. This study is based on elements of Critical Social Theory. As methodological procedures we use: analysis of documents; literature review; semi structured interviews and focus group. We consider that even with the progress made with the development of the National Policy of STD / AIDS in relation to women's health it’s perceived objectively a series of contradictions in its effectiveness because the antiretroviral treatment alone does not solve the range of problems arising from the infection. In addition to antiretroviral guarantee, it is necessary the access to drugs against opportunistic diseases and expanding access to specialists. In interviews with professionals of referral service we realize individual performance of each, although occur concern in guiding women on contraceptives and methods of breeding the best possible way. A major difficulty pointed out by these professionals was the high demand for care in relation to the number of professionals; reflection of the current situation of the Brazilian public health, precariousness, underfunding, privatization. In focus group we noticed the lack of knowledge of women on reproductive and sexual rights, reflected in unsafe practices to prevent and difficulty to negotiate condom use with their partners. We believe that ignore / deny the reproductive and sexual rights of women living with HIV / AIDS does not mak ver their lives and more consciously make sexual and reproductive choices; and the professionals who accompany them have the role of supporting the decisions adopted and the recognition of the risks and benefits assumed from certainties situations or uncertainties, advantages or disadvantages