Factors associated with pregnancy uptake decisions among seropositive HIV people receiving antiretroviral therapy in sub-Saharan Africa: A systematic review.
Abdul Razak Doat, Roberta Mensima Amoah, Kennedy Diema Konlan and 5 others
PMID 35643950WHAT IT FOUND
For women living with HIV in sub-Saharan Africa, factors shaping pregnancy decisions included wanting children, prevention of mother-to-child transmission knowledge, marriage expectations, income, contraception, burden, low CD4 count, and negative nurse attitudes.
Key findings
01A desire for children was reported as a motivator for pregnancy uptake in 83% of included studies.
02Modern contraception availability and pregnancy as a health or financial burden were reported as demotivators.
03Negative nurse attitudes were reported as a reason some women avoided pregnancy, including advice not to become pregnant and scolding at antenatal visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 12 articles, and the studies used different designs, populations and measures, so the findings cannot be treated as one consistent effect. The search was limited to English articles from January 2016 to January 2021 and four databases, so relevant studies may have been missed. The paper does not report a formal quality appraisal or risk-of-bias assessment of the included studies. The included studies report associations and experiences, not tested interventions, so they do not show whether counselling or care changes pregnancy decisions. The review excluded studies about the influence of antiretroviral therapy on pregnancy and mother-to-child transmission, so it does not address those questions directly.
The easy way to misread this
Do not conclude that negative nurse attitudes alone cause women to avoid pregnancy. The review reports them as one of several associated factors from heterogeneous studies, not as a tested causal relationship.