Parenting intentions of young sexual minority men living with HIV in Mexico City, Mexico.

Young sexual minority men are disproportionately affected by HIV in Mexico. Little is known about their thoughts about childbearing, an issue complicated by sexual identity and HIV serostatus. We conducted 16 in-depth qualitative interviews to explore the parenting desires of young sexual minority men living with HIV in Mexico City. Domains of the questionnaire included (1) parenting desires, (2) preferences about different methods (e.g. adoption, in-vitro fertilisation), and (3) perceived barriers to becoming a father. A modified grounded theory approach was used for qualitative analysis. Participants ranged in age from 17 to 21 years and had been living with HIV for an average of 15 months. Most expressed the desire to have a child in the future but were uninformed as to their options for doing so. Participants largely preferred adoption, citing the perceived risk of HIV transmission as a deterrent to using assisted reproductive technologies. Some participants expressed the desire to have a child that was genetically their own, but shared doubts as to the feasibility. The majority of participants stated that the topic of childbearing had never come up during the course of their HIV care.

Gender, power and intimate relationships over the life course among Ethiopian female peer educators living with HIV.

Historically, Ethiopian women have faced numerous challenges to gender equity at the individual, relational and community levels; such inequalities can lead to increased risk of HIV acquisition. Over the past two decades, some progress has been made towards changing policies and norms to reduce gender inequality. We sought to understand the ways in which marriage and other romantic/sexual relationships of a group of Ethiopian women living with HIV had been impacted by gender norms, relational power dynamics and HIV status over the life course. We conducted in-depth interviews with 19 women living with HIV who were working as peer educators at a large clinic in Addis Ababa, Ethiopia. Reflecting on their early lives, participants often described traumatic prior relationships characterised by rape, forced marriage and HIV nondisclosure. In the aftermath of being diagnosed with HIV, participants' more recent relationships embodied a more egalitarian dynamic characterised by mutual support for HIV care engagement and open communication. Participants' narratives illustrate encouraging examples of ways in which HIV-positive women can form and maintain equitable and satisfying personal relationships even in the context of obstacles at multiple levels.

Spirituality, social capital and service: factors promoting resilience among Expert Patients living with HIV in Ethiopia.

People living with HIV (PLHIV) in Ethiopia and other developing nations face numerous challenges to their health and well-being, including poverty, limited healthcare infrastructure and high levels of societal stigma. Despite these challenges, resilient trajectories have been observed even within such resource-limited settings. In Ethiopia, such resilience is exemplified by the 'Expert Patients (EPTs)', HIV-positive lay health workers who function as adherence counsellors, health educators, outreach workers and community advocates. We conducted a multi-method qualitative study with 20 EPTs in Addis Ababa, Ethiopia in order to understand pathways to resilience in this selected population. Participants described three key mechanisms of resilient coping: (1) the use of spirituality and faith-based practices to manage psychological difficulties associated with living with HIV; (2) utilisation of social capital from family and community networks as a buffer against the psychological and economic consequences of societal stigma; and (3) serving others as a mechanism for finding optimism and purpose in life. Interventions designed to facilitate and/or augment these social processes in the wider community may be promising strategies for improving health among PLHIV in Ethiopia and other resource-limited settings.