Fertility Desires and Intentions and the Relationship to Consistent Condom Use and Provider Communication regarding Childbearing among HIV Clients in Uganda

Abstract

Objectives HIV prevention and reproductive health programs emphasize consistent condom use and preventing unplanned pregnancies, but do not account for the childbearing desires of many HIV clients. We examined the correlates of fertility desires and intentions, including condom use, among HIV clients in Uganda. Methods Baseline data from a prospective cohort study of clients starting antiretroviral therapy were analyzed. All measures were self-report, except abstracted CD4 count. Results The sample included 767 clients; 34% were men and 50% had a primary sex partner. Among those with a desire (31%) or intention (24%) for having a child in the near future, 60% had not discussed this with providers. A majority (61%) had received advise about family planning, and 27% were told by their provider that they should not bear a child because of their HIV status. In regression analysis, male gender, younger age, higher CD4, having fewer children, and having a primary partner were significantly associated with fertility desires and intentions; having been told by one’s provider not to have a child was associated with intentions but not desires. Among participants with a primary partner, consistent condom use was greater among those with no fertility intentions, as was receipt of advise about family planning, while HIV disclosure to partner was greater among those with intentions. Partner HIV status was not associated with fertility desires or intentions. Conclusions These findings highlight the need for HIV care and reproductive health programs to incorporate safer conception counseling and improve provider/patient communication regarding childbearing.

Pregnancy desire and dual method contraceptive use among people living with HIV attending clinical care in Kenya, Namibia and Tanzania

“…These findings therefore provide important insights into the social and clinical correlates of reproductive health behaviours and the service needs of PLHIV attending HIV clinical care. Only 17% of participants reported desiring a pregnancy in the next 6 months, an estimate lower than other studies among PLHIV in sub-Saharan Africa including studies from Nigeria (63%), Tanzania (37%), Uganda (31%) and South Africa (29%), 15–1739 but higher than estimates from Uganda (8%) and Rwanda (8%). 3137 Significant correlates of fertility desire included being currently married, having fewer children, and being in a recent relationship.…”

“…3137 Significant correlates of fertility desire included being currently married, having fewer children, and being in a recent relationship. Other studies have also found that having fewer children 1519222337 and duration of relationship 16 were important predictors of fertility desire among PLHIV.…”

“…3240 Unfortunately, studies indicate that providers have not received training on how to provide safer pregnancy counselling, 40 and some have unsupportive attitudes toward fertility desires in HIV-positive patients. 151941 …”

“…Finally, fertility desire and fertility intentions were not measured as separate constructs, and some literature has shown these two constructs to be different. 15 …”

Modern Contraceptive Utilization and Associated Factors among HIV Positive Women on Antiretroviral Therapy in Mizan-Tepi Teaching and Referral Hospital, South-West Ethiopia

“…In sub-Saharan Africa, the main mode of HIV transmission is through heterosexual sex with a concomitant epidemic in children through vertical transmission [4]. Despite the risk of mother to child transmission of HIV, significant proportion of parents living with HIV continued to desire to have children [5][6][7][8]. Studies also revealed that HIV-positive women encountered unintended pregnancies with associated risk of mother to child transmission of HIV [9][10][11].…”