Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Mar;9(1):2-12.

The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda

Jolly Beyeza-Kashesya  1 , Frank Kaharuza, Florence Mirembe, Stella Neema, Anna Mia Ekstrom, Asli Kulane
Affiliations

The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda

Jolly Beyeza-Kashesya et al. Afr Health Sci. 2009 Mar.

Abstract

Background: Sixty percent of new HIV infections in Uganda occur in stable relationships between HIV discordant couples. Given the importance of fertility in Uganda, we hypothesized that unsafe sexual practices may be used to found a family/replace a dead child. Thus, we explored sexual practices to understand to what extent these are influenced by the desire to have children and the implications for HIV transmission among discordant couples.

Methods: A cross-sectional survey of 114 HIV discordant couples in Kampala, and in-depth interviews with 15 purposively selected couples. Quantitative data were analysed using STATA. Multivariate logistic regression analysis done to identify factors associated with consistent condom use. Thematic content analysis of qualitative data was done using NVIVO 2.

Results: Participants wanting children and those with multiple sexual partners were less likely to use condoms (Adj OR 0.51, and 0.36 respectively). Three of the five types of sexual practices used by couples do not allow pregnancy to occur. Main reasons for wanting a child included: ensuring lineage continuity and posterity, securing relationships and pressure from relatives to reproduce. Challenges included: risk of HIV transmission to partner and child, lack of negotiating power for safer sex, failure of health systems to offer safe methods of reproduction

Conclusions: HIV sero-discordant couples with strong desire for childbearing have a dilemma of risking HIV infection or infecting their spouse. Some risk transmission of HIV infection to reproduce. We need to address gender issues, risky behaviour and reproductive health services for HIV sero-discordant couples.

Keywords: HIV Sero-discordance; condom use; desire for children.

PubMed Disclaimer

References

    1. Ministry of Health (MOH) [Uganda] and ORC Macro, author. Uganda HIV/AIDS Sero-behavioral Survey 2004–2005. Calverton, Maryland, USA: Ministry of Health and ORC Macro; 2006.
    1. Merson M. Uganda's HIV/AIDS Epidemic: Guest Editorial. AIDS Behav. 2006;10(4):333–334.
    1. Bunnell R E, NasozziI J, Marum E, Mubangizi J, Malamba S, Killon B, Kalule J, Bahizi J, Musoke N, Mermin J H. Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. Clin Infect Dis. 2005;17(8):999–1012. - PubMed
    1. Nakayiwa S, Abang B, Packel L, Lifshay J, Purcell D W, King R, Ezati E, Mermin J, Coutinho A, Bunnell R. Desire for Children and Pregnancy Risk Behavior among HIV-Infected Men and Women in Uganda. AIDS Behav. 2006;10:S95–S104. - PubMed
    1. Olley B O, Seedat S, Stein D J. Self disclosure of HIV serostatus in recently diagnosed patients with HIV in South Africa. Afr J Reprod Health. 2004;8(2):71–76. - PubMed

LinkOut - more resources