Barriers to comprehensive fertility counseling among persons living with HIV/AIDS in Ghana
- 1Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology , ,
- 2Department of Health Information Management, University of Cape Coast , ,
Abstract
Introduction: Persons living with HIV/AIDS (PLWHA) in Ghana increasingly express the wish to have children, yet little is known about whether routine HIV care delivers fertility counseling that extends beyond prevention of mother-to-child transmission to the safer conception, individualized planning, and onward referral that comprehensive counseling requires. This study explored the barriers to comprehensive fertility counseling experienced by PLWHA receiving antiretroviral therapy at a district hospital in the Ashanti Region of Ghana.
Methods: A qualitative interpretive phenomenological design was used. Twelve purposively selected adults living with HIV, comprising nine women and three men aged 26–49 years, attended the antiretroviral therapy clinic at St. Michael's Hospital, Pramso, and took part in in-depth semi-structured interviews between August and October 2024. Interviews were audio-recorded, transcribed verbatim, and analyzed manually through an inductive interpretive phenomenological process that moved from meaning units to situated interpretation and then to essential themes. Trustworthiness was supported through reflexive journaling, documented positionality, participant validation of preliminary interpretations, and an audit trail.
Results: Three essential themes captured how healthcare experiences shaped fertility counseling and decision-making, namely quality of reproductive health counseling and education, healthcare provider attitudes and support, and access to comprehensive reproductive health services. Participants valued prevention of mother-to-child transmission education and the relational warmth of providers, yet described counseling that was generic rather than tailored to their circumstances and that seldom addressed protection of an HIV-negative partner during conception. No participant reported being offered or receiving a referral, preconception consultation, or structured reproductive plan when personal barriers such as absence of a partner stood in the way of childbearing. One participant had received no fertility counseling at all.
Discussion: These accounts left participants holding reproductive hopes they could not translate into plans. The findings suggest that at this facility fertility counseling is routinely delivered but, as experienced by these participants, incompletely comprehensive, and that structured individualized planning, provider capacity in safer conception, and clearly communicated referral pathways deserve attention.
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BibTeX
@article{boadi2026barriers,
title = {{Barriers to comprehensive fertility counseling among persons living with HIV/AIDS in Ghana}},
author = {Priscilla Asantewaa Boadi and Victor Luckyboy Dzramado},
journal = {Frontiers in reproductive health},
year = {2026},
month = oct,
doi = {10.3389/frph.2026.1914739},
url = {https://europepmc.org/article/PMC/PMC13719461},
note = {CC BY},
}
RIS
TY - JOUR
TI - Barriers to comprehensive fertility counseling among persons living with HIV/AIDS in Ghana
AU - Priscilla Asantewaa Boadi
AU - Victor Luckyboy Dzramado
PY - 2026
DA - 2026/10/16
JO - Frontiers in reproductive health
DO - 10.3389/frph.2026.1914739
UR - https://europepmc.org/article/PMC/PMC13719461
AB - Introduction: Persons living with HIV/AIDS (PLWHA) in Ghana increasingly express the wish to have children, yet little is known about whether routine HIV care delivers fertility counseling that extends beyond prevention of mother-to-child transmission to the safer conception, individualized planning, and onward referral that comprehensive counseling requires. This study explored the barriers to comprehensive fertility counseling experienced by PLWHA receiving antiretroviral therapy at a district hospital in the Ashanti Region of Ghana. Methods: A qualitative interpretive phenomenological design was used. Twelve purposively selected adults living with HIV, comprising nine women and three men aged 26–49 years, attended the antiretroviral therapy clinic at St. Michael's Hospital, Pramso, and took part in in-depth semi-structured interviews between August and October 2024. Interviews were audio-recorded, transcribed verbatim, and analyzed manually through an inductive interpretive phenomenological process that moved from meaning units to situated interpretation and then to essential themes. Trustworthiness was supported through reflexive journaling, documented positionality, participant validation of preliminary interpretations, and an audit trail. Results: Three essential themes captured how healthcare experiences shaped fertility counseling and decision-making, namely quality of reproductive health counseling and education, healthcare provider attitudes and support, and access to comprehensive reproductive health services. Participants valued prevention of mother-to-child transmission education and the relational warmth of providers, yet described counseling that was generic rather than tailored to their circumstances and that seldom addressed protection of an HIV-negative partner during conception. No participant reported being offered or receiving a referral, preconception consultation, or structured reproductive plan when personal barriers such as absence of a partner stood in the way of childbearing. One participant had received no fertility counseling at all. Discussion: These accounts left participants holding reproductive hopes they could not translate into plans. The findings suggest that at this facility fertility counseling is routinely delivered but, as experienced by these participants, incompletely comprehensive, and that structured individualized planning, provider capacity in safer conception, and clearly communicated referral pathways deserve attention.
SN - 2673-3153
ER -