Barriers to Pregnancy Spacing in Women Living with HIV: A Series of Informational Interviews

For reproductive-age women living with HIV, birth spacing allows for optimization of maternal health and viral suppression to prevent mother-to-child transmission of HIV. We conducted semi-structured informational interviews to explore use of contraception for birth spacing. Interviews were transcribed and analyzed. Audio files were reviewed to capture non-explicit data. We interviewed 18 multiparous HIV positive women. All described experiences with at least one contraceptive method. Six themes emerged: Burden of contraception, Failure of birth control, Impact of youth and lack of life experience, Community beliefs about birth control, Lack of partner cooperation, and Altruism. Women viewed birth spacing favorably. Young age at first delivery, contraceptive side effects, non-adherence to short-acting methods, lack of partner cooperation, and prior contraceptive failure were identified as barriers to ideal birth spacing. Additional outreach is needed in women living with HIV to overcome barriers to planned pregnancy and birth spacing.