Purpose: To explore the gender-based power relationships and social and cultural influences on reproductive decision-making processes among HIV-positive couples in Taiwan. Methods: The study sample consisted of 14 HIV-positive couples in southern Taiwan. Data were analyzed using feminist ethnography to explore reproductive decisions made by these couples within the context of Taiwanese society. Findings: Self-knowledge of HIV status had a limited influence on decisions about child-bearing. More important was the Confucian values of filial piety and familial obligation, a powerful norm that still dictates procreation decisions in Taiwan. The process by which the couples made reproductive decisions consisted of four stages: initial reproductive decisions between partners, their search for information, their encounters with medical systems, and their weighing risks and benefits. Male and female partners expressed different concerns, and gender-based power relationships were exercised during the decision-making process. Conclusions: HIV status was not the sole determinant of reproductive decisions made by HIV-positive couples. Rather, the Confucian value of filial piety drove the couples' reproductive decisions.
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