Considering childbearing in the age of highly active antiretroviral therapy (HAART): Views of HIV-positive couples

Abstract

Objectives: Based on a qualitative study conducted in Bulawayo, Zimbabwe, this article examines how the availability of HAART
since April 2004 may impact the views and choices of HIV-positive couples on childbearing.
Methods: In-depth interviews were conducted with 15 couples where at least one partner was HIV positive. All respondents were of
reproductive age and had or were confronting reproductive and sexual decision-making.
Results: HAART seems to have had a profound impact on the subject of childbearing among those who still desire to have children.
Where hitherto individuals had only a desire for a child many are now, as a result of the availability of HAART, actively planning
to have one. HAART has not only transformed their physical state but it has also transformed mostly what had been desire into
intention. The impact, however, has not been uniform. Some respondents still desired to have a child but were not yet convinced
about the efficacy of HAART in preventing vertical transmission. Some respondents felt that HAART may have a negative impact on
the foetus and as such were against childbearing by HIV-positive people. No respondent indicated that their desire or intention to
have a child had been extinguished by the advent of HAART.
Conclusion: Based on the findings of the study, HAART seems to have had a differential but nonetheless significant role in the
reproductive plans of HIV-positive couples. The study also notes that there is a need to make available complete and unbiased
information on HAART, mother-to-child transmission risk (MTCT) and pregnancy to HIV-positive couples so as to enable them to
make informed decisions.