The Gender Context of HIV Risk and Pregnancy Goals in Western Kenya.

Background: Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children.

Objective: To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services in western Kenya among men and women.

Design: Community-based formative qualitative study design.

Setting: Five administrative/geographical divisions of Nyando District, western Kenya.

Subjects: Adult men 18 years and older and women who were of reproductive-potential ages (15 to 49 years for females) (n=90).

Results: Men and women have disparate goals for number of children and engage in gendered patterns of protective method use (contraceptives used by women often in secret, condoms by men but rarely).

Conclusion: HIV infection was still seen as stigmatizing. These study results are relevant to design of effective integrated delivery for reproductive and HIV services in high-burden sub-Saharan African countries.