Number of pregnancies, outcome expectancies, and social norms among HIV-infected young women.

Abstract

In this descriptive study, researchers examined pregnancies, sexually transmitted diseases (STDs), and sexual behaviors among 67 HIV-infected young women, as well as the women's outcome expectancies and peer and partner norms regarding pregnancy. Many of the women (69%) had been pregnant; 42% had been pregnant at least once since learning their HIV status, with 71% choosing to carry to term, resulting in 25% (N = 5) of the babies infected. The women had positive outcome expectancies related to pregnancy, which were significantly correlated with peer and partner social norms. Lack of knowledge regarding infant transmission, high rates of STDs, and inconsistent condom use all indicate a need for improved intervention regarding pregnancy and decision-making. Suggestions for better methods of providing information to HIV+ young women are provided.Factors that influence pregnancy and knowledge of the consequences of HIV seropositivity were explored in interviews with 67 HIV-infected young US women (mean age, 19.9 years) recruited from AIDS medical clinics in New York, New York; San Francisco, California; Los Angeles, California; and Miami, Florida. 69% of respondents had been pregnant prior to their HIV diagnosis. Since learning of their HIV serostatus, 42% had been pregnant at least once and 71% of these women carried the child to term; five of the infants were HIV-positive. Of the 33 women who had children, 23 reported that the child lived at home with them. The average correct HIV/AIDS knowledge score was 71%. 38% were unaware that a pregnant HIV-positive woman can lower the risk of maternal-fetal transmission by taking medication and 17% did not know that breast-feeding can transmit HIV. Women who became pregnant after learning they were HIV-positive were no more likely to get these items correct, suggesting that HIV-infected women are not being counseled adequately about pregnancy. Although 68% thought the infant of an HIV-infected mother was at high risk of HIV transmission, 43% expected their peers would be supportive if they wanted a baby and 56% anticipated a positive response from their partner. Most women believed they would be able to care for a baby, without the need for parental involvement or foster care placement. Positive outcome expectancies related to pregnancy, as well as partner and peer social norms, may influence young HIV-positive women's pregnancy-related decisions.