The Impact of Antenatal HIV Diagnosis on Postpartum Reproductive Behaviour in Northern Tanzania

Sarah Keogh, London School of Hygiene and Tropical Medicine (LSHTM)
Mark Urassa, National Institute for Medical Research, Tanzania
Maria Roura, London School of Hygiene and Tropical Medicine (LSHTM)
Yusufu Kumogola, National Institute for Medical Research, Tanzania
Basia Zaba, London School of Hygiene and Tropical Medicine (LSHTM)

With HIV testing increasingly offered as a routine part of antenatal care in Africa, many women will discover they are HIV+ during pregnancy. It is important to examine the impact of HIV diagnosis on postpartum reproductive behavior, and to tailor antenatal counseling to HIV+ women’s needs. This is the first study to provide adjusted measures of the effect of diagnosis on postpartum reproductive behavior. A baseline survey of 5,682 antenatal clients inquired about reproductive behavior before HIV testing/counseling. HIV results were linked to survey answers. Fifteen months later, a follow-up survey collected information on postpartum reproductive behavior, and in-depth interviews explored attitudes to childbearing and HIV. HIV diagnosis caused a downward adjustment in childbearing desires, but did not affect short-term desires, in contrast to findings from previous studies. Qualitative research uncovered major factors discouraging childbearing post-diagnosis, but also factors pushing women to continue childbearing. Implications for antenatal counseling are discussed.