Knowing Client Rights and Meeting Their Needs: Provider Knowledge and Attitudes Toward Meeting the Reproductive Needs and Rights of People Living with HIV in South Africa

With the widespread availability of antiretroviral treatment (ART), men and women living with HIV are living longer and healthier lives. Many of these men and women are of reproductive age and are having children or expressing the desire for children. Prevention of mother-to-child transmission (PMTCT) care has focused on preventing HIV transmission to children. A critical next step is addressing horizontal transmission between partners during conception. Providers face many challenges in the delivery of care to PLHIV which is further complicated by the call to address their reproductive needs. Despite the call to integrate HIV and reproductive health services the integration of such services faces many challenges, still falling far short of meeting the reproductive rights and needs of clients. We conducted focus group and in-depth qualitative interviews with 25 health care providers in a rural and urban ARV clinic in KwaZulu-Natal. We found that health care providers struggled to balance their perceptions of client reproductive rights and their personal attitudes and professional experiences in addressing these needs. Furthermore, despite the publication of national guidelines for safer conception, health care providers still have limited knowledge or training in safer conception strategies for PLHIV. This chapter highlights provider ambivalence in knowing and meeting reproductive rights and needs of PLHIV.