Pregnancy and Abortion among HIV-positive women in Zambia and Nigeria: Comparing Attitudes of HIV-Positive Women and Health Care Providers

Using a sample of HIV-positive women (n=353) and men (n=299) from Nigeria and Zambia as well as their health care providers (n=179), we examine attitudes towards childbearing and abortion among HIV-positive women on individual measures as well as an index. Support for HIV-positive women to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already has an HIV-positive child. Support for childbearing among the HIV-positive was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than support from providers. Support for abortion varied more depending on the measure. Half of all respondents indicated no/low support for abortion on the index measure while between 2 to 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion for HIV-positive women indicate that HIV does not seem to qualify for most respondents as a medical condition which justifies abortion. While integrating HIV and family planning services remains challenging, increased medical and social education about childbearing while managing HIV may have the potential to reduce stigma and help HIV-positive individuals meet their reproductive goals.