Objectives: Poor interpersonal relationships with women
especially those living positively with HIV/AIDS can make them
take risks that would expose their new born and others to infection
during childbirth. The factors that influence childbirth choices
of people living positively with HIV/AIDS (PLWHA) deserve
attention. Sometimes, women, especially PLWHA, for several
reasons, resort to the use of other health care services instead of
the general hospitals equipped for ante-natal care (ANC). This
study aims to identify factors and conditions that determine
childbirth choices of PLWHA in the Abia State of Nigeria.
Methods: A cross-sectional descriptive study was carried out
using a total sample of 96 PLWHA who attend meetings with
the network of PLWHA and also a purposive convenience
sample of 45 health workers. Data collection instruments were
questionnaire, focus group discussions and interview guides. Data
was analyzed both qualitatively and quantitatively using simple
percentages.
Results: There was a low patronage for hospital services. A total
of 79 (82%) PLWHA did not use hospital services due to the
lack of confidentiality. In total, 61 (64%) PLWHA had their
childbirth with Traditional Birth Attendants (TBAs) at home.
Embarrassment, rejection, interpersonal conflicts with health
workers, non-confidentiality, cultural stigma and stigmatization
were among the factors that encouraged childbirth choices. On
the whole, 82 (85%) of the PLWHA discontinued ANC services
because of stigmatization.
Conclusion: Poor interpersonal relationships between health
workers and PLWHA facilitated PLWHA childbirth choices
more than other factors. PLWHA and health workers termed
management of belligerent tendencies against each other as
their greatest concern. Therefore, concerted effort is needed to
improve health workers/PLWHA relationship in hospitals. This
would minimize factors and/or conditions that encourage HIV
infection. Exposing PLWHA to factors that influence childbirth
at home demonstrates high risks of mother-to-child transmission,
infection to others and obstetric complications.