Marseille 2007
| Abstract #353 - Holding the line: Vietnamese family responses to pregnancy and child desire when a family member has HIV | ||||
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Session: 17.1: Challenges for Children (Parallel) on Monday @ 14.00-16.00 in Auditorium/Overflow Chaired by Patrice Engle, Christina Noestlinger Authors: Presenting Author: Ms Pauline Oosterhoff - Amsterdam School for Social Research, Viet Nam |
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| Additional Authors: Ms Pauline Oosterhoff, | ||||
| Aim: Health services around the world have many guidelines for HIV positive women who are pregnant or who want to become pregnant and for women with HIV infected partners. These guidelines are addressed to the women and increasingly also to the men but pay little or no attention to the role of other members of the family in fertility decisions. This study looked into the factors influencing decisions about fertility in families with an HIV-infected member in Vietnam. | ||||
| Method / Issue: Qualitative and quantitative data were collected for this study in Hanoi and in Thai Nguyen City, two urban areas in Northern Vietnam. HIV infected pregnant women, HIV+ mothers, their partners, family members, and health workers were interviewed about child desire, HIV infection, family, PMTCT, ARV, health care and social support. In each city the study interviewed staff involved in PMTCT, resulting in 275 semi-structured interviews with health care workers. Health officials were also interviewed as stakeholders and key informants. In Hanoi and Thai Nguyen, we interviewed 56 seropositive women using semi-structured questionnaires. In addition, focus group discussions on child desire, HIV infection, family, PMTCT, health and care were held with two groups of 12 men and 10 women in two rehabilitation centres for drug users and sex workers in Ba Vi (Ha Tay province near Hanoi). All of the urban respondents were recruited from support groups and through health sites that had routine testing prior to delivery. Participatory observation of the mothers was continued through two years of program activities. The researchers also interviewed Vietnamese policy makers, social service providers and other key informants and reviewed popular media. | ||||
| Results / Comments: A clear pattern emerged: if a family does not yet have a male heir, there is pressure on the couple to produce a male offspring, regardless of the HIV status of the man and the woman. When the couple was responsible for the lineage and there was not yet a male heir, pressure was felt in 18 of 20 cases, according to both partners of the couple. If they already had a boy, they did not feel pushed (9 cases). Couples who were not responsible for the lineage felt little pressure to produce a male child, whether or not they already one. | ||||
| Discussion: In Vietnam the whole family takes a crucial role in deciding whether a woman should become pregnant and whether she will keep her child. This decision is taken in the context not only of the close family but also under the influence of ancestors and their weight in the culture. Key in this regard is the need for parents and grandparents to have male offspring. Health workers share these ideas about preferred family composition and support men and women in the quest for male offspring. Policies and guidelines should take into account these additional family factors and targets as a basis for the design of appropriate interventions to reduce the spread of HIV. | ||||
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