American Journal of Social Sciences revealed that there is evidence of a decline in the number of births per woman in Botswana. The Journal says although the number of women desiring children is on the rise, one of the main challenges to achieving this is HIV/AIDS.
The study identified factors that influence desires for child bearing among human immunodeficiency virus (HIV) positive women of child bearing ages.
Failure to give birth in Botswana is viewed as norm violation. Thus, women’s ability to give birth is seen as a source of identity, social standing, and individual recognition, and through these conventions, partnership stability and financial security.
HIV-positive women often find themselves torn between conflicting socio-cultural expectations as their desire for childbearing are viewed as a violation of beliefs about acceptable mothering. HIV-positive women have to deal with numerous life challenges like public assistance, attitudes of peers and family members, stigma associated with childbearing by HIV-infected women.
The study says HIV positive women have fertility desires and may intend to have children as many women do. However, very little is known about the extent of these desires, intentions and decision making, and how these differences, if any, differ by individual’s social and demographic characteristics.
In Botswana 300,000 adults, nearly a quarter of the population over age 15, are living with HIV. Half of these are on antiretroviral drugs (ARVs), and 95,000 children are orphans due to acquired immune deficiency syndrome (AIDS). Despite health complications associated with HIV, HIV-positive women of childbearing age continue to express the desire and commitment to bear children.
According to National AIDS coordinating Agency (NACA) (2009) out of 11,292 deliveries, 3,615 (32%) were of HIV-positive women. 27% of these HIV women were on Highly Active Anti Retroviral Therapy (HAART) during delivery at the same period, suggesting an increase in women who were either aware that they are HIV positive or were very sick with AIDS at the time they got pregnant.
Despite the government of Botswana’s efforts to provide free HIV and AIDS related health services such as Prevention of Mother to Child Transmission (PMTCT), pre and post HIV diagnosis counselling, and anti-retroviral drugs in public health facilities, only 22 percent (152 out of a total 691) of pregnant women knew about their HIV-positive status before becoming pregnant in Gaborone alone.
The study says in Botswana, the environment is rapidly changing as most men receive some information concerning the devastating effects of HIV/AIDS on the individual lives of women who are often compelled against their will to have children.
Furthermore; the study says social and health concerns of people living with HIV in the environment of Botswana presents a set of more complex reasons for desiring children that may include their health in addition to their cultural background and personality traits. HIV-related factors, such as quality of life, use of antiretroviral drugs, time since diagnosis of infection, disclosure status and stage of disease progression are possible motivational traits among the population of Botswana.