“I don't base my Faith in Doctors”: Perceptions of Women living with HIV/AIDS (WLHA) to Health Care Workers Advice on Childbearing Intentions in Lagos, Nigeria

Background: The purpose of this study is to explore the perceptions of Women living with HIV/AIDS (WLHA) and their adherence to healthcare workers (HCW) advice on their childbearing intentions and the impact on their actual childbearing activities. Methods: Sixty interviews were conducted with WLHA attending a hospital in Lagos, Nigeria. Interview questions explored how supportive WLHA felt HCW were in addressing their reproductive needs. Interviews, lasting for 40 minutes, were audio-taped, and transcribed. Results: Participants' age ranged from 20- 45 years, with an average of 5 years since HIV diagnosis. Using content analysis three major themes emerged: 1) Doctors are not God; 2) God's time to have children; and 3) hope of giving birth to a negative child. Most of the women reported that they were advised by HCW to wait until their CD4 count was high before getting pregnant. Majority of these women viewed this advice as counter to “God's time,” because “you don't know how God does his work.” They believed that doctors are not God that could “program the time” for pregnancy since “it's God that provides children at his own appointed time.” Many women reported getting pregnant without informing HCW, while some women reported informing HCW when they were ready to have children because “our gain for life is to have children that are negative.” Conclusion: These findings indicate the need to take into account the perceptions surrounding the advice WLHA receive from HCW and the implications these may have for reproductive and family planning services.