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Browse Subject Areas? In the past decade, worldwide, there Prostitutes Mbuguni been a steady Prostitutes Mbuguni in research, service delivery, and advocacy to support women living with HIV to make informed decisions about whether, when, and how to become mothers [ 1311 — 25 ].

In bivariate analysis, Prostitutes Mbuguni for children was not significantly associated with education level, having received a viral load test in the past six months, self-reported viral suppression, use of modern contraception, or awareness of at least one safer conception strategy.

In multivariate analysis, the only factors that were significantly associated with desire for children were having a nonpaying partner Prostitutes Mbuguni odds ratio [AOR] 2. This study corroborates and substantiates the burgeoning research documenting the desire for children among women living with HIV, and the indisputable need and opportunity to provide explicit safer conception counseling and services to these women [ 1 — 7 ].

At minimum, a FP discussion presents a teachable opportunity Prostitutes Mbuguni impress upon HIV-positive women that there are effective biomedical and behavioral strategies that Prostitutes Mbuguni, in some cases, virtually eliminate the possibility of transmitting HIV to a partner or to an infant. Some of Prostitutes Mbuguni strategies—such as sperm washing—are not widely available for most HIV-positive women in Tanzania [ 57 ], but ART Prostitutes Mbuguni and timed condomless sex are arguably readily accessible as safer conception options.

The finding that those who wanted children imminently were no more likely to report viral suppression is concerning. One would hope that women living with HIV who are contemplating pregnancy would be aware of and supported to achieve viral suppression to minimize risk of HIV transmission to Prostitutes Mbuguni seronegative partner.

Furthermore, informing HIV-positive women of the possibility of having a safe pregnancy has the potential to motivate her to remain Prostitutes Mbuguni treatment and seek timely antenatal care. Study participants were not only women living with HIV, but they were also women who sell sex.

Due to Prostitutes Mbuguni internal and external stigma, both women and providers alike may believe that HIV-positive FSWs are inherently uninterested in or unfit to have children, but our study findings demonstrate that a sizable proportion of these women aspire to become mothers, Prostitutes Mbuguni complete their families among those who already are mothers.

Notably, Cernigliaro and colleagues Prostitutes Mbuguni 58 ] reported that, among FSWs in the Dominican Republic, internalized stigma was associated with greater fertility desire; becoming a mother may provide these marginalized women with a Prostitutes Mbuguni of self-worth and acceptance [ 58 ].

The finding that those with nonpaying partners have a higher odds of wanting children is intuitive, since these nonpaying partners often are men with whom FSWs have more intimate relationships than with paying clients.

Findings from previous research supports this hypothesis; some FSWs report less consistent condom use with nonpaying partners because they feel that condoms compromise the intimacy of the sexual relationship, or they aspire to Prostitutes Mbuguni pregnant with those partners [ 5960 ]. As articulated Prostitutes Mbuguni by Ippoliti and colleaguesfemale key populations such as FSWs have a host of sexual and reproductive health needs, among which safer conception services often are neglected [ 61 ].

Results should be interpreted with the study context and limitations in mind. Sauti community-based sites Prostitutes Mbuguni a range of services beyond FP, and study participants were not necessarily proactively seeking FP counseling. In addition, to contextualize the low reported prevalence of recent viral load Prostitutes Mbuguni and self-reported viral suppression, it is worth underscoring that women are recommended to receive viral load testing within six months of treatment initiation, and once a year thereafter.

In addition, viral load testing may not always be available due to, for example, reagent stockouts or insufficient maintenance of viral load testing machines. Nevertheless, the finding that there was no significant correlation between fertility desire and either of these measures remains concerning. Moving forward, providers would benefit from guidance about the minimum FP screening and counseling that they should offer at every clinical interaction with HIV-positive women, Prostitutes Mbuguni explicit consideration of how to Prostitutes Mbuguni the possibility of having children in the future.

Policymakers and service delivery organizations in Tanzania and elsewhere can consider building on existing national guidelines from South Africa, consensus statements from safer conception researchers and advocates for people living with HIV PLHIVand a safer conception Prostitutes Mbuguni that has been tested in Kenya, for instance [ 1917 Prostitutes Mbuguni.

In addition, once PrEP becomes available more widely, this may present an opportunity to test the acceptability of pre-conception PrEP for seronegative Prostitutes Mbuguni in mixed-status relationships. Adolescent girls and young women remain disproportionately burdened by HIV in sub-Saharan Africa, and as they age into their reproductive years, Prostitutes Mbuguni question of whether and how to have children will become increasingly salient.

As demonstrated by our Prostitutes Mbuguni, FSWs are no exception to this reality. The growing consensus among researchers and advocates alike is that there is an urgent need for policies and programs to help HIV-positive women achieve Prostitutes Mbuguni, while minimizing HIV risk [ 1 ].

This study was made possible by the women and providers who generously shared their Prostitutes Mbuguni and experiences with the study team, as well as the peer educators who supported Prostitutes Mbuguni recruitment Prostitutes Mbuguni study participants.

We also thank the CSK interviewers and observers for their diligent data collection efforts. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Background With the advent of effective treatment, women living with HIV can plan for pregnancy while minimizing risk of transmission to infants and seronegative partners.

Results Median age of participants was Materials and methods Setting Study sites were existing Sauti community-based service delivery points in Dar es Salaam.

Data collection Prostitutes Mbuguni The cross-sectional study design consisted of multiple data collection activities at or near selected community-based FP service delivery sites for FSWs living with HIV in Dar es Salaam run by Sauti.

Client exit interviews. Variables and data analysis The research team conducted descriptive analyses of the exit interview data, calculating simple frequencies to describe the demographic characteristics of participants, as well as their fertility-related needs and knowledge, including awareness of Prostitutes Mbuguni interest in safer conception strategies.

Results Of the Prostitutes Mbuguni invited by peer educators to participate in the study, 39 were found to be ineligible upon screening by interviewers at study sites. Download: PPT. Table 1. Table 2. Discussion This study corroborates and substantiates Prostitutes Mbuguni burgeoning research documenting the desire for children among women living with HIV, and the indisputable need and opportunity to provide explicit safer conception counseling and services to these women [ 1 — 7 ].

Supporting information. S1 File.

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Client exit interview survey instrument—English. S2 File.

Client exit interview Prostitutes Mbuguni instrument—Kiswahili. Acknowledgments This study was made possible by the women and providers who generously shared their time and experiences with the study team, as well as the peer educators who supported the recruitment of study participants. References Prostitutes Mbuguni.

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Consensus statement: supporting safer conception and pregnancy for men And women living with and affected by HIV.

AIDS Behav. A systematic review of the current status of safer conception strategies for HIV affected heterosexual couples in sub-Saharan Africa. Fertility intentions of prenatal Prostitutes Mbuguni postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: Prostitutes Mbuguni longitudinal study. View Article Google Scholar 5.

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Factors associated with desire for children among HIV-infected women and men: a quantitative and qualitative analysis from Malawi and implications for the delivery of safer conception counseling. AIDS Care. Fertility desire among HIV-positive women in Tigray region, Ethiopia: implications for the provision of Prostitutes Mbuguni health and prevention of mother-to-child HIV transmission services. BMC Womens Health.

The Lancet HIV. Lancet HIV. Guideline on safer conception in fertile HIV-infected individuals and couples. View Article Google Scholar World Health Organization. Consolidated guideline Prostitutes Mbuguni sexual and reproductive health and rights of women living with HIV.

Geneva: World Health Organization; Salamander Trust. Building a safe house on firm ground: key findings from a global values and preferences survey regarding the sexual and reproductive health and human rights of women living with HIV. Safer conception interventions for Prostitutes Mbuguni couples: implications for resource-constrained settings. Top Antivir Med. Implementing a Prostitutes Mbuguni prophylaxis intervention for safer conception among HIV serodiscordant couples: recommendations for health care providers.

J Health Dispar Res Pract. Study protocol of "Our Choice": a randomized controlled Prostitutes Mbuguni of the integration of safer conception counseling to transform HIV family planning services in Uganda. Implement Sci. Prevalence and correlates of use Prostitutes Mbuguni safer conception methods in a prospective cohort of Ugandan HIV-affected couples with fertility intentions.

A novel safer conception counseling toolkit for the prevention of HIV: a mixed-methods evaluation in Kisumu, Kenya.

Establishing conception intentions and safer conception services for eliminating the vertical, and reducing the horizontal, transmission of HIV. Achieving pregnancy safely: perspectives on timed vaginal insemination Prostitutes Mbuguni HIV-serodiscordant couples and health-care providers in Kisumu, Kenya.

Challenges with Prostitutes Mbuguni, serodiscordance and HIV disclosure: healthcare provider perspectives on delivering safer conception services for HIV-affected couples, South Africa.

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The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's Prostitutes Mbuguni task force on family planning and HIV service integration.

Family planning for HIV-positive girls and young women.

Supporting people living with Prostitutes Mbuguni in serodiscordant partnerships to attempt a desired pregnancy by integrating sexual and reproductive health and HIV interventions. Canadian HIV pregnancy planning guidelines. J Obstet Gynaecol Can. HIV Med. Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV Prostitutes Mbuguni Uganda.

PLoS One. Providers' perspectives on preconception Prostitutes Mbuguni and safer conception for HIV-infected women. Provider attitudes about childbearing and knowledge of safer conception at two HIV clinics in Malawi.

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Int Perspect Sex Reprod Health. J Acquir Immune Defic Syndr. Integration of family planning services into HIV care and Prostitutes Mbuguni services: a systematic review. Stud Fam Plann. Family planning counseling for women living with HIV: Prostitutes Mbuguni systematic review of the evidence of effectiveness on contraceptive uptake and pregnancy incidence, to BMC Public Health. Integration of family planning into HIV services: a synthesis of recent evidence.

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Provider attitudes about childbearing and knowledge of safer conception at two HIV clinics in Malawi. Discussion This study corroborates and substantiates the burgeoning research documenting the desire for children among women living with HIV, and the indisputable need and opportunity to provide explicit safer conception counseling and services to these women [ 1 — 7 ]. Among people living with HIV who do not sell sex, Saleem et al.

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