Provider Attitudes toward Discussing Fertility Intentions with HIV-Infected Women and Serodiscordant Couples in the USA

Background

Recent research suggests that pregnancy is a potentially safe option for couples with at least one HIV-infected adult. Data regarding provider discussion of fertility intentions with women living with HIV (WLWH) or in serodiscordant relationships is limited.

Methods

We conducted a cross-sectional self-administered survey of health professionals who provide HIV services to women in order to assess knowledge and behaviors regarding family planning options for HIV-infected women and serodiscordant couples.

Results

Of 77 respondents, 47(61%) met the inclusion criteria (health care provider who cares for WLWH). Approximately half (57%) of the participants indicated that they always or usually discuss contraception or fertility intentions with their HIV+ female patients of reproductive age. When asked to indicate their awareness of techniques to decrease HIV transmission risk among serodiscordant couples attempting pregnancy, most participants reported awareness of multiple options. Discussion of contraception or fertility intentions was not associated with provider gender, age, and experience in caring for HIV-infected patients, previous training in women’s health or provider’s awareness of options to decrease transmission risk.

Conclusions

HIV providers in this study were knowledgeable of practices that can lead to safer conception and prevent HIV transmission among individuals in serodiscordant relationships but did not always discuss this information with their patients. Further research is needed to explore optimal methods for encouraging such conversations.

Emergency contraception: providers' knowledge and attitudes and their relationship with users' knowledge and attitudes at public health centers/posts of tabriz

INTRODUCTION

Emergency contraceptives are accessible and acceptable methods for most women, which their proper use could prevent about three quarters of unwanted pregnancies. In this study, we aimed to determine the providers' knowledge, attitudes and their relation with the pills and condoms users' knowledge of and attitudes towards emergency contraception at public health centers/posts in Tabriz, Iran.

METHODS

In this cross-sectional study, subjects were 140 health providers working in randomly selected 19 health centers and 33 health posts and 280 married women aged 15 to 49 years who were using contraceptive pills or condoms (two clients of each selected provider). A self-administered questionnaire was used to collect data from the providers, while the questionnaire for the clients was filled up by face-to-face interview. The relationships were determined by Pearson's correlation test.

RESULTS

Mean score of the providers' knowledge and attitude was 69.4 ± 11.8 and 70.1 ± 12.8, respectively (possible score range was 0-100). The providers' knowledge score was good only in 35% (score > 75.0). High majority (95.7%) had positive attitudes (score > 50.0). Overall, there were no sig-nificant relationships, neither between the provider's and users' knowledge nor between their attitudes (p > 0.05).

CONCLUSION

The providers' knowledge was insufficient, and there was no significant association between the providers' and users' knowledge and attitudes. Thus, in addition to the need for promoting providers' knowledge, the other barriers should also be recognized and removed in order to promote using this method.