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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda</title><author><name sortKey="Beyeza Kashesya, Jolly" sort="Beyeza Kashesya, Jolly" uniqKey="Beyeza Kashesya J" first="Jolly" last="Beyeza-Kashesya">Jolly Beyeza-Kashesya</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kaharuza, Frank" sort="Kaharuza, Frank" uniqKey="Kaharuza F" first="Frank" last="Kaharuza">Frank Kaharuza</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Mirembe, Florence" sort="Mirembe, Florence" uniqKey="Mirembe F" first="Florence" last="Mirembe">Florence Mirembe</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Neema, Stella" sort="Neema, Stella" uniqKey="Neema S" first="Stella" last="Neema">Stella Neema</name><affiliation><nlm:aff id="A3">Makerere University Institute of Social Research, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Ekstrom, Anna Mia" sort="Ekstrom, Anna Mia" uniqKey="Ekstrom A" first="Anna Mia" last="Ekstrom">Anna Mia Ekstrom</name><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kulane, Asli" sort="Kulane, Asli" uniqKey="Kulane A" first="Asli" last="Kulane">Asli Kulane</name><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20842236</idno><idno type="pmc">2932519</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2932519</idno><idno type="RBID">PMC:2932519</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">001553</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001553</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda</title><author><name sortKey="Beyeza Kashesya, Jolly" sort="Beyeza Kashesya, Jolly" uniqKey="Beyeza Kashesya J" first="Jolly" last="Beyeza-Kashesya">Jolly Beyeza-Kashesya</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kaharuza, Frank" sort="Kaharuza, Frank" uniqKey="Kaharuza F" first="Frank" last="Kaharuza">Frank Kaharuza</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Mirembe, Florence" sort="Mirembe, Florence" uniqKey="Mirembe F" first="Florence" last="Mirembe">Florence Mirembe</name><affiliation><nlm:aff id="A1">Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Neema, Stella" sort="Neema, Stella" uniqKey="Neema S" first="Stella" last="Neema">Stella Neema</name><affiliation><nlm:aff id="A3">Makerere University Institute of Social Research, Kampala Uganda</nlm:aff></affiliation></author><author><name sortKey="Ekstrom, Anna Mia" sort="Ekstrom, Anna Mia" uniqKey="Ekstrom A" first="Anna Mia" last="Ekstrom">Anna Mia Ekstrom</name><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kulane, Asli" sort="Kulane, Asli" uniqKey="Kulane A" first="Asli" last="Kulane">Asli Kulane</name><affiliation><nlm:aff id="A2">Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</nlm:aff></affiliation></author></analytic><series><title level="j">African Health Sciences</title><idno type="ISSN">1680-6905</idno><idno type="eISSN">1729-0503</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec sec-type="methods"><title>Methods</title><p>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.</p></sec><sec sec-type="results"><title>Results</title><p>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</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>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.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Afr Health Sci</journal-id><journal-title-group><journal-title>African Health Sciences</journal-title></journal-title-group><issn pub-type="ppub">1680-6905</issn><issn pub-type="epub">1729-0503</issn><publisher><publisher-name>Makerere Medical School</publisher-name><publisher-loc>Kampala, Uganda</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20842236</article-id><article-id pub-id-type="pmc">2932519</article-id><article-id pub-id-type="publisher-id">jAFHS.v9.i1.pg2</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Beyeza-Kashesya</surname><given-names>Jolly</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kaharuza</surname><given-names>Frank</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mirembe</surname><given-names>Florence</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Neema</surname><given-names>Stella</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Ekstrom</surname><given-names>Anna Mia</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kulane</surname><given-names>Asli</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Obstetrics/Gynaecology, Makerere University, Kampala Uganda</aff><aff id="A2"><label>2</label>Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</aff><aff id="A3"><label>3</label>Makerere University Institute of Social Research, Kampala Uganda</aff><author-notes><corresp><bold>Corresponding author</bold> Jolly Beyeza-Kashesya Department of Obstetrics/Gynaecology Makerere University, Kampala Uganda Email: <email>jbeyeza@yahoo.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>3</month><year>2009</year></pub-date><volume>9</volume><issue>1</issue><fpage>2</fpage><lpage>12</lpage><permissions><copyright-statement>Copyright © Makerere Medical School, Uganda 2009</copyright-statement></permissions><abstract abstract-type="executive-summary"><sec><title>Background</title><p>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.</p></sec><sec sec-type="methods"><title>Methods</title><p>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.</p></sec><sec sec-type="results"><title>Results</title><p>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</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>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.</p></sec></abstract><kwd-group><kwd>HIV Sero-discordance</kwd><kwd>condom use</kwd><kwd>desire for children</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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