Reproductive Decision-Making in the Context of HIV And AIDS: A Qualitative Study in Ndola, Zambia

International Family Planning Perspectives 25–35% of infants born to HIV-infected women become infected themselves.1 In some areas of Sub-Saharan Africa, vertical transmission of HIV has led to rising child mortality rates, eroding the hardwon gains of child survival programs.2 Moreover, the children who escape infection from their HIV-positive mothers are likely to join the rapidly growing number of children orphaned by parents who have died of AIDS. For example, in Zambia, the Ministry of Health estimates that by 2000 more than 500,000 children younger than 15 had been orphaned by the AIDS deaths of their mothers or of both parents. If present trends in Zambia continue, the number of AIDS orphans will increase to more than one million by 2010.3 The promotion of family planning services among HIV-positive women can prevent and reduce births of children who have a high probability of dying from AIDS or being orphaned upon the death of one or both of their parents.* In the absence of antiretroviral prophylaxis and affordable, safe breast-milk substitutes, the principal strategies to prevent HIV infection in infants are HIV prevention in women and men and couples’ use of contraception when the woman is HIV-posiNaomi Rutenberg is senior program associate, Horizons project, Population Council, Washington, DC. Ann E. Biddlecom is research investigator, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Frederick A.D. Kaona is senior principal scientific officer at the Tropical Diseases Research Centre, and director, Mwengu Social and Health Research Centre, Ndola, Zambia. The study on which this article is based was funded by the Population Council’s Africa Operations Research/Technical Assistance Project (Project No. 9363030, funded by the U. S. Agency for International Development) and by The Rockefeller Foundation. An earlier version of this article was presented at the annual meeting of the Population Association of America, Washington, DC, March 27–29, 1997. The authors thank Mary Mufaya, Gladys Ngoma and Joyce Mulenga for conducting the field work for this project, and Andy Fisher, John Casterline and Ellen Weiss for their comments on earlier drafts of this paper. Reproductive Decision-Making in the Context of HIV And AIDS: A Qualitative Study in Ndola, Zambia