Fertility desire and associated factors among people living with HIV attending antiretroviral therapy clinic in Ethiopia

BMC Pregnancy and Childbirth

Temamen Tesfaye¹  Bosena Tebeje¹  Dereje Bayissa Demissie² 

[1] Department of Nursing and Midwifery, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia;Department of Nursing and Midwifery, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia

关键词: Fertility desires;    Ethiopia;    People living with HIV;   

Others  :  1091582
DOI  :  10.1186/s12884-014-0382-2

 received in 2013-11-30, accepted in 2014-10-23,  发布年份 2014

【 摘 要 】

Background

The reproductive decisions made by PLHIV and their partners have a long-term consequences for the survival and wellbeing of their families and a society at large. Evidence relating to fertility and reproductive intentions among PLHIV is rare, despite the fact that more than 80% of PLHIV are of reproductive age. The aim of the study was to determine fertility desire and associated factors among PLHIV attending ART clinic in Fitche Hospital.

Methods

A facility based cross-sectional study design with both quantitative and qualitative data collection methods was employed from February21-April 20th, 2013. The study participants were selected by using simple random sampling technique. A pre- tested structured questionnaire was used to collect data. Both bivariate and multivariate logistic regressions were used to identify associated factors.

Result

The prevalence of fertility desire of PLHIV in Fitche Hospital was 133(39.1%) with 95% CI of (34.3% -44.3%). This study identified that factors found to be associated with fertility desire were: − Age from 18-29y [AOR = 3.95, 95% CI: 1.69 - 9.22) and 30-39y (AOR = 3.91, 95% CI: 1.90 -8.19)], marital length ≤4y [AOR = 5.49, 95% CI: 2.08-14.51), within 5-9y (AOR = 4.80, 95% CI: 2.14-10.78) and 10-14y (AOR = 2.82, 95% CI: 1.19 -6.63], had not biological living children [AOR = 11.42, 95% CI: 3.27-39.90) and had more than one child (AOR = 3.67, 95% CI: 1.27-10.62)], community pressure [AOR = 3.67, 95% CI: 1.54-8.70], partner fertility [AOR = 7.18, 95% CI: 3.39-15.22)], duration HIV diagnosis≤1y[AOR = 4.99, 95% CI: 1.91-13.09], disclosed HIV serostatus [AOR = 3.9, 95% CI: 1.37-11.10] and partner sero-difference [AOR = 2.05, 95% CI: 1.01- 4.15] were some of the factors significantly associated with fertility desire.

Conclusion

The prevalence of fertility desire of PLHIV in the study area was 39.1%. In this study:- age, marital length, biological child, partner, community pressure, duration of HIV-diagnosis, discordant HIV-test and disclosure of HIV-serostatus to partner were demonstrated to have more associations with fertility desire among PLHIV, therefore, these factors should be emphatically considered during PLHIV’s reproductive health program development.

【 授权许可】

   
2014 Demissie et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1][http://www.unicef.org/aids/files/aids_togetherwewillendaids_en.pdf] webcite Joint United Nations Programme on HIV/AIDS(UNAIDS, Together We Will End AIDS report ©2012 .
• [2][http:/ / www.unaids.org/ sites/ default/ files/ media_asset/ 20121120_UNAIDS_Global_Report_2012_ with_annexes_en_1.pdf] webcite Global HIV AND AIDS Response: WHO/UNAIDS/UNICEF November 2011. .
• [3]Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia, Maryland, USA: Central Statistical Agency and ICF International Calverton; 2012.
• [4]Kodzi I, David J, John C: Examining the predictive value of fertility preferences among Ghanaian women. Demogr Res 2010, 22(30):965-984.
• [5]Cooper D, Jane Harries LM, Orner P, Bracken H: "Life is still going on": Reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med 2007, 65(2):274-283.
• [6]Oosterhoff P, Anh NT, Hanh NT, Yen PN, Wright P, Hardon A: Holding the line: Family responses to pregnancy and the desire for a child in the context of HIV in Vietnam. Cult Health Sex 2008, 10(4):403-416.
• [7]Delvaux T, Nöstlinger C: Reproductive choice for women and Men living with HIV: contraception, abortion and fertility. Reproductive Health Matters 2007, 15(29, Supple 1):46-66.
• [8]Segurado AC, Paiva V: Rights of HIV positive people to sexual and reproductive health:parenthood. Reproductive Health Matters 2007, 15(29, Supplement 1):27-45.
• [9]Spaulding AB, Bain Brickley D, Caitlin Kennedy LA, Laura Packel JM, Gail Kennedy LC, Osborne K: Linking family planning with HIV/AIDS interventions: a systematic review of the evidence. AIDS 2009, 23:S79-S88.
• [10]Hosegood V: The demographic impact of HIV and AIDS across the family and household life-cycle: implications for efforts to strengthen families in sub-Saharan Africa. AIDS Care 2009, 21(sup1):13-21.
• [11]Guidelines for Prevention of Mother-to-Child Transmission of HIV in Ethiopia. FHAPCO, Addis Ababa; 2007.
• [12]Nóbrega AA, Oliveira FAS, Galvão MTG, Mota RS, Regina M, Barbosa ID, Kendall C, Kerr-Pontes LR: Desire for a child among women living with HIV/AIDS in northeast brazil. AIDS Patient Care & STDs 2007, 21(4):261-267.
• [13]Cooper D, Jennifer Moodley VZ, Linda-Gail Bekker IS, Myer L: 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 2009, 13(supplement 1):38-46.
• [14]Nattabi B, Jianghong Li ST, Orach C, Earnest J: Family planning among people living with HIV in post-conflict Northern Uganda: A mixed methods study. Confl Heal 2011, 5(1):18. BioMed Central Full Text
• [15]Yeatman S: The impact of HIV status and perceived status on fertility desires in rural Malawi. AIDS Behav 2009, 13:12-19.
• [16][www.starjournal.org] webcite Regassa T, Fantahun M: Fertility Desire and Reproductive Health Care Needs of Men and Women Living with HIV/AIDS in Nekemte, East Wollege, Ethiopia.Sci Technol Arts Res J 2012, 1(3):31-38. . ISSN: 2226-7522.
• [17]Smith DJ, Mbakwem BC: Antiretroviral therapy and reproductive life projects: Mitigating the stigma of AIDS in Nigeria. Soc Sci Med 2010, 71(2):345-352.
• [18][http://www.reproductive-healthjournal.com/content/8/1/27] webcite Kipp W, Heys J, Jhangri GS, Alibhai A, Rubaale T: Impact of antiretroviral therapy on fertility desires among HIV-infected persons in rural Uganda.Reprod Health 2011, 8(27). , doi: 10.1186/1742-4755-8-27.
• [19]Aska ML, Chompikul J: Determinants of fertility desires among HIV positive women living in the Western highlands province of Papua New Guinea BoonyongKeiwkarnka. World Journal of AIDS ASEAN Institute for Health Development Mahidol University, Thailand 2011, 1:198-207.
• [20]Tamene W, Fantahun M: Fertility desire and family-planning demand among HIV-positive women and men undergoing antiretroviral treatment in Addis Ababa, Ethiopia African Journal of AIDS Research 2007. Afr J Aids Res 2007, 6(3):223-227. Printed in South Africa
• [21]Finocchario-Kessler S, Michael Sweat JD, Maria Trent DK, Keller J, Anderson J: Understanding high fertility desires and intentions among a sample of urban women living with HIV in the United States. AIDS Behav 2010, 14(5):1106-1114.
• [22]Kaida A, Laher F, Strathdee SA, Janssen PA, Money D, Hogg RS, Gray G: Childbearing intentions of HIV-positive women of reproductive Age in Soweto, south africa: the influence of expanding access to HAART in an HIV hyperendemic setting. Am J Public Health 2011, 101(2):350-358.
• [23]Kakaire O, Osinde M, Kaye D: Factors that predict fertility desires for people living with HIV infection at support and treatment centre in Kabale. Uganda. Reprod Health 2010, 7(1):27. BioMed Central Full Text
• [24]Iliyasu Z, Isa Abubakar MK, Musa Babashani FS, Aliyu MH: Correlates of fertility intentions among HIV/AIDS patients in northern Nigeria. Afr J Reprod Health 2009, 13(3):71-83.
• [25]Paiva V, Naila Santos IF-J, Elvira Filipe JRA, Segurado A: Desire to have children: gender and reproductive rights of Men and women living with HIV: a challenge to health care in brazil. AIDS Patient Care & STDs 2007, 21(4):268-277.
• [26]Agadjanian V: Fraught with ambivalence:reproductive intentions and contraceptive choices in a Sub-Saharan fertility transition. Popul Res Policy Rev 2005, 24(6):617-645.
• [27]Wagner G, Sebastian Linnemayr CK, Mugyenyi P: Factors associated with intention to conceive and its communication to providers: among HIV clients in Uganda.Matern Child Health J 2011:1–9. ISSN: 1573-6628; Print ISSN 1092-7875.
• [28]Getachew M, Alemseged F, Abera M, Deribew A: Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone. Northeast Ethiopia. Ethiop J Health 2010, 24(3):214-220.
• [29]Simpore J, Compaore E, Sawadogo J, Djigma F, Ouermi D, Martinetto M, Pietra V, Fabó F, ten Have HAMJ, García A: Human immunodeficiency virus prevention among HIV-serodiscordant couples in Burkina Faso: bioethical and cultural challenges. World J AIDS 2011, 1:185-191.