Research article

Societal and individual drivers of fertility desires and intentions among people living with HIV: a cross sectional study of HIV clinic attendees in Soweto, South Africa

  • Received: 30 August 2021 Accepted: 30 November 2021 Published: 20 December 2021
  • Background 

    High proportion of people living with HIV (PLHIV) who are in the prime of their reproductive years desire to have children. There are limited studies that explore the range of fertility intentions for PLHIV. This study investigated the fertility desires and intentions of PLHIV and the associated factors.

    Methods 

    This was a cross-sectional study of 442 PLHIV receiving antiretroviral treatment (ART) in health facilities in Soweto, an urban township that is situated in the City of Johannesburg in South Africa. STATA version 13 was used to analyze the data.

    Results 

    The participants' mean age was 36.3 years, 70% were females, 79.6% had at least one biological child, and 36% had 3+ children. Almost half (47%) expressed the desire for children, saying that this was because they had no biological children, or their partners wanted children, or they wanted children of a particular sex, or were feeling healthy after taking ART. An increased fertility desire was associated with absence of biological children (AOR = 5.06, 95% CI: 2.11–12.1) and with being married (AOR = 2.63, 95% CI: 1.31–5.27). A decreased fertility desire was associated with being aged 36+ (AOR = 2.63, 95% CI: 1.31–5.27), having primary education (AOR = 0.11, 95% CI: 0.01–1.30) and having ≥4 years of ART duration (AOR = 0.45, 95% CI: 0.24–0.81).

    Conclusion 

    Individual factors played a significant role in shaping the fertility desires of PLHIV in this setting. The high desire for children underscore the need to integrate reproductive health services in HIV and AIDS care and treatment services and develop safer conception programmes to help PLHIV to conceive and have children safely.

    Citation: Penelope Chirambira, Sphiwe Madiba, Busisiwe Ntuli. Societal and individual drivers of fertility desires and intentions among people living with HIV: a cross sectional study of HIV clinic attendees in Soweto, South Africa[J]. AIMS Public Health, 2022, 9(1): 173-184. doi: 10.3934/publichealth.2022013

    Related Papers:

  • Background 

    High proportion of people living with HIV (PLHIV) who are in the prime of their reproductive years desire to have children. There are limited studies that explore the range of fertility intentions for PLHIV. This study investigated the fertility desires and intentions of PLHIV and the associated factors.

    Methods 

    This was a cross-sectional study of 442 PLHIV receiving antiretroviral treatment (ART) in health facilities in Soweto, an urban township that is situated in the City of Johannesburg in South Africa. STATA version 13 was used to analyze the data.

    Results 

    The participants' mean age was 36.3 years, 70% were females, 79.6% had at least one biological child, and 36% had 3+ children. Almost half (47%) expressed the desire for children, saying that this was because they had no biological children, or their partners wanted children, or they wanted children of a particular sex, or were feeling healthy after taking ART. An increased fertility desire was associated with absence of biological children (AOR = 5.06, 95% CI: 2.11–12.1) and with being married (AOR = 2.63, 95% CI: 1.31–5.27). A decreased fertility desire was associated with being aged 36+ (AOR = 2.63, 95% CI: 1.31–5.27), having primary education (AOR = 0.11, 95% CI: 0.01–1.30) and having ≥4 years of ART duration (AOR = 0.45, 95% CI: 0.24–0.81).

    Conclusion 

    Individual factors played a significant role in shaping the fertility desires of PLHIV in this setting. The high desire for children underscore the need to integrate reproductive health services in HIV and AIDS care and treatment services and develop safer conception programmes to help PLHIV to conceive and have children safely.



    加载中

    Acknowledgments



    The authors appreciate the facility staff for their assistance and support.

    Conflict of interest



    The authors declare no conflict of interest.

    [1] Bekker L, Black V, Myer L, et al. (2011) Guideline on safer conception in fertile HIV-infected individuals and couples: guideline. S Afr J HIV Med 12: 31-44. doi: 10.4102/sajhivmed.v12i2.196
    [2] Gutin SA, Namusoke F, Shade SB, et al. (2014) Fertility desires and intentions among HIV-positive women during the post-natal period in Uganda. Afr J Reprod Health 18: 67-77.
    [3] Van Zyl C, Visser MJ (2015) Reproductive desires of men and women living with HIV: implications for family planning counselling. Reprod Biomed Online 31: 434-442. doi: 10.1016/j.rbmo.2015.06.004
    [4] Beyeza-Kashesya J, Ekstrom AM, Kaharuza F, et al. (2010) My partner wants a child: a cross-sectional study of the determinants of the desire for children among mutually disclosed sero-discordant couples receiving care in Uganda. BMC Public Health 10: 1. doi: 10.1186/1471-2458-10-247
    [5] Cooper D, Moodley J, Zweigenthal V, et al. (2009) Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services. AIDS Behav 13: 38. doi: 10.1007/s10461-009-9550-1
    [6] Mmbaga EJ, Leyna GH, Ezekiel MJ, et al. (2013) Fertility desire and intention of people living with HIV/AIDS in Tanzania: a call for restructuring care and treatment services. BMC Public Health 13: 86. doi: 10.1186/1471-2458-13-86
    [7] Rispel LC, Metcalf CA, Moody K, et al. (2011) Sexual relations and childbearing decisions of HIV-discordant couples: an exploratory study in South Africa and Tanzania. Reprod Health Matter 19: 184-193. doi: 10.1016/S0968-8080(11)37552-0
    [8] Wekesa E, Coast E (2014) Fertility desires among men and women living with HIV/AIDS in Nairobi slums: a mixed methods study. PLoS One 9: e106292. doi: 10.1371/journal.pone.0106292
    [9] Krashin JW, Haddad LB, Tweya H, et al. (2018) Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi. PloS One 13: e0198798. doi: 10.1371/journal.pone.0198798
    [10] Hussen Mekonnen FE (2017) Effect of antiretroviral therapy on changes in the fertility intentions of human immunodeficiency virus-positive women in Addis Ababa, Ethiopia: a prospective follow-up study. Epidemiol Health 39.
    [11] Matovu JK, Makumbi F, Wanyenze RK, et al. (2017) Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study. Reprod Health 14: 2. doi: 10.1186/s12978-016-0272-3
    [12] Adilo TM, Wordofa HM (2017) Prevalence of fertility desire and its associated factors among 15-to 49-year-old people living with HIV/AIDS in Addis Ababa, Ethiopia: a cross-sectional study design. Hiv/aids (Auckland, NZ) 9: 167.
    [13] Bakeera-Kitaka S, Nabukeera-Barungi N, Nöstlinger C, et al. (2008) Sexual risk reduction needs of adolescents living with HIV in a clinical care setting. AIDS Care 20: 426-433. doi: 10.1080/09540120701867099
    [14] Mokgatle M, Molapisi E, Madiba S (2017) The childbearing desires of perinatally infected female adolescents enrolled in an HIV clinic in Tshwane District, Gauteng Province, South Africa. Curr Pediatr Res .
    [15] Ngure K, Baeten JM, Mugo N, et al. (2014) My intention was a child but I was very afraid: fertility intentions and HIV risk perceptions among HIV-serodiscordant couples experiencing pregnancy in Kenya. AIDS Care 26: 1283-1287. doi: 10.1080/09540121.2014.911808
    [16] Cooper D, Harries J, Myer L, et al. (2007) “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med 65: 274-283. doi: 10.1016/j.socscimed.2007.03.019
    [17] Ayieko J, Ti A, Hagey J, et al. (2017) HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study. Reprod Health 14: 93. doi: 10.1186/s12978-017-0355-9
    [18] Demissie DB, Tebeje B, Tesfaye T (2014) Fertility desire and associated factors among people living with HIV attending antiretroviral therapy clinic in Ethiopia. BMC Pregnancy Childb 14: 1-10. doi: 10.1186/s12884-014-0382-2
    [19] Kaoje A, Ibrahim M, Njoku C, et al. (2015) Predictors of fertility desire among people living with HIV attending anti-retroviral clinic in a tertiary health facility in Sokoto, Northern Nigeria. Sahel Med J 18: 14. doi: 10.4103/1118-8561.152153
    [20] Mantell JE, Smit JA, Stein ZA (2009) The right to choose parenthood among HIV-infected women and men. J Public Health Pol 30: 367-378. doi: 10.1057/jphp.2009.35
    [21] Banjo OO, Akinyemi JO (2018) Spousal and household characteristics associated with Women's fertility in sub-Saharan Africa. JPSS 26: 13-31. doi: 10.25133/JPSSv26n1.002
    [22] Haile F, Isahak N, Dessie A (2014) Fertility desire and associated factors among people living with HIV on ART. Harari Regional State Eastern Ethiopia J Trop Dis 2.
    [23] Sofolahan YA, Airhihenbuwa CO (2013) Cultural expectations and reproductive desires: experiences of South African women living with HIV/AIDS (WLHA). Health Care Women Int 34: 263-280. doi: 10.1080/07399332.2012.721415
    [24] Kawale P, Mindry D, Stramotas S, et al. (2014) Factors associated with desire for children among HIV-infected women and men: a quantitative and qualitative analysis from Malawi and implications for the delivery of safer conception counseling. AIDS Care 26: 769-776. doi: 10.1080/09540121.2013.855294
    [25] Barnabas RV, Szpiro AA, van Rooyen H, et al. (2020) Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial. Lancet Glob Health 8: e1305-e1315. doi: 10.1016/S2214-109X(20)30313-2
    [26] Wagner GJ, Wanyenze R (2013) Fertility desires and intentions and the relationship to consistent condom use and provider communication regarding childbearing among HIV clients in Uganda. Int Scholarl Res Notices 2013.
    [27] Ahinkorah BO, Seidu AA, Armah-Ansah EK, et al. (2020) Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control. BMC Pregnancy Childb 20: 1-11. doi: 10.1186/s12884-020-03470-1
    [28] Raosoft I Sample size calculator, 2004 Available from: https://www raosoft com/samplesize.
    [29] Agbo S, Rispel LC (2017) Factors influencing reproductive choices of HIV positive individuals attending primary health care facilities in a South African health district. BMC Public Health 17: 540. doi: 10.1186/s12889-017-4432-3
    [30] Shrestha N, Pokharel R, Poudyal A, et al. (2020) Fertility Desire and Its Determinants Among People Living with HIV in Antiretroviral Therapy Clinic of Teku Hospital, Nepal. Hiv/aids (Auckland, NZ) 12: 41.
    [31] Abebe M, Endazenaw G (2015) Fertility Intention and Family Planning use Among People Living with HIV/AIDS (PLHIV) on Follow up Care Western Shoa Zone, Anti Retroviral Treatment (ART) Unit, Oromia, Ethiopia. AASRJETS 12: 75-91.
    [32] Tekoh LR, Tesoh AH, Tanjoh NS, et al. (2016) Fertility Desire and Reproductive Health Education Needs of Women Living with HIV Receiving Care at Regional Hospital Limbe HIV Treatment Centre. J Adv Med Med Res 1-13.
    [33] Koyra HC, Biramo YB, Tufa EG (2017) Fertility desire and associated factors among people living with HIV/AIDs at selected health facilities of Wolaita Zone, Southern Ethiopia: cross-sectional study. Am J Public Health Res 5: 79-88.
    [34] Mujugira A, Heffron R, Celum C, et al. (2013) Fertility Intentions and Interest in Early Antiretroviral Therapy among East African HIV-1 Infected Individuals in Serodiscordant Partnerships. J Acq Imm Def Synd 63: e33. doi: 10.1097/QAI.0b013e318288bb32
  • Reader Comments
  • © 2022 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(2245) PDF downloads(71) Cited by(0)

Article outline

Figures and Tables

Tables(3)

Other Articles By Authors

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog