Men's and women's roles in decision making about abortion in the context of HIV.

OBJECTIVE

Mother-to-child transmission of HIV is a matter of global concern but is particularly serious in Zimbabwe. A number of strategies have been identified to limit the risk of mother-to-child transmission, including abortion. The aim of the current study was to assess men's and women's roles in decision making about abortion in a setting with a high prevalence of HIV.

METHODS

Qualitative research based on eight focus group discussions was conducted among adult men and women in Gokwe North District, Zimbabwe.

RESULTS

Both men and women expressed strong, negative attitudes towards abortion. Often, HIV-infected women considered carrying their pregnancy to term so as to fulfil societal and cultural expectations of childbirth after marriage. Termination of pregnancy by HIV-infected women was discouraged due to the availability of highly active antiretroviral drugs. Fear of giving birth to a sick and HIV-infected child, however, remained high. Also, the restricted legal environment appeared to complicate HIV-positive women's decisions to abort. Male involvement in decision making about abortion was relatively limited; if women opted for termination of pregnancy they were likely to do so secretly without obtaining their partner's consent.

CONCLUSIONS

In the context of HIV, it is important for prevention programmes to target both men and women in order to reduce the risk of mother-to-child transmission.