| Summary: | Research regarding pregnancy and women living with HIV does exist, however, in-depth qualitative research about the decision making process concerning around pregnancy and the pregnancy journey for women living with HIV is absent from both the international and Thai literature. This qualitative research study employs the constructivist grounded theory method to understand and generate a model of the pregnancy decision making process and continue with their pregnancy in Thai women living with HIV. Data collection was done in antenatal clinics (ANCs), at two provincial hospitals located in the Northeast of Thailand. In-depth semi-structured interviews were conducted with 15 HIV positive pregnant women. Data analysis involved open coding, making-memos and using the constant comparative method to develop a grounded theory substantive model of HIV pregnancy decision making. The substantive model consists of 6 categories; 1) concealing HIV positive status from husband; 2) desire to have a child; 3) becoming pregnant; 4) keeping or terminating pregnancy; 5) accepting a decision; and 6) adapting to a decision. This research finds that the main concerns women living with HIV in deciding to have a child are balancing fear, concealing HIV status and the information that they have in each decision making step. Based on the research findings, a unique process of decision making has been found among these women that related to personal and Thai social beliefs. This study recommends that health care providers need to pay more attention to counselling women living with HIV and couples by giving sufficient contraceptive information to prevent unplanned and unwanted pregnancy, to support and guide the women who want and plan for pregnancy in advance of this happening and helping women to deal with HIV disclosure issues related to morality and the rights of couples. Moreover, respect and support must be accorded to HIV positive women about their right to have a child if they choose to do so.
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