Fertility intention and use of contraception among women living with the human immunodeficiency virus in Oromia Region, Ethiopia

Abstract

Background: The human immunodeficiency virus (HIV) epidemic resulted in decreased fertility among HIV-positive women, who did not want to transmit the virus to their unborn children. With the availability of antiretroviral therapy that suppresses viral load, HIV-infected women live normal lives and even acknowledge the desire and intention to have children, a factor that is rarely acknowledged in antiretroviral therapy (ART) clinic services. This study examined fertility intentions and contraception use among a sample of women attending an ART clinic in Oromia Region, Ethiopia.
 
 Methods: A quantitative, cross-sectional and descriptive design was used on a sample of 362 HIV-positive women. Data were collected using a researcher-administered questionnaire.
 
 Results: The ages of the participants ranged from 18 to 49 years and most were between the ages of 23 and 32. A desire and intention to fall pregnant was reported by 46.6% (n = 158) of the participants. A total of 114 (35.5%) had given birth after they were diagnosed with HIV and 4% were pregnant at the time of the study. Of the study participants who wanted to have children, 60.7% (n = 82) planned to have a child within two years. In the period before they were diagnosed with HIV, most participants used injectable contraceptives but this changed to using the condom after they were diagnosed with HIV.
 
 Conclusion: The high number of women who have both the desire and intention to have children among this sample of HIV-positive women requires that reproductive health services need to include family planning as an essential component of reproductive health services. The change to using the condom as a contraceptive method indicates the positive impact of health promotion received at ART clinic.
 
 (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
 
 S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1254931

Fertility intentions and associated factors of HIV positive women of reproductive age in JOS, Northcentral Nigeria

“…A signifi cantly higher proportion of those who used contraceptives had less desire for more children. This is consistent with the fi nding in a study in Ethiopia [24]. On the other hand, the use of contraceptives did not emerge as a reliable predictor of fertility intention in another study in Ontario, Canada [34].…”

“…This was lower than other previous studies carried out in Jos, north-central Nigeria (60%), Sagamu -southwest Nigeria (63.3%), Abia, south-east Nigeria (63.7%) and Maiduguri, north-east Nigeria (71.5%) [20][21][22][23]. However, it was consistent with results obtained from studies in Oromia region and Addis-Ababa in Ethiopia where similar proportion of women from the two studies expressed desire for more children [24,25]. On the other hand, it was higher than that observed in a study in the USA where less than a third of the women were desirous of more children [26].…”

“…This may be because nearly three-quarters of these women are in the early phase (1-5years) of their marriages when the desire to procreate is highest. This is similar to a study in Ethiopia where, out of the respondents who desired children, 60% planned to have children within 2 years [24]. It may suggest that the women in this study have similar aspirations with regards to future fertility desires as other women living with HIV from other African countries.…”

“…The intention to have children was negatively associated with the use of contraceptive. This is in keeping with studies in Ethiopia and Papua New Guinea [24,32]. Similarly, a multicentre study conducted in some peri-urban communities in sub-Saharan Africa among women in the general population, showed that women who didn't want more children reported more contraceptive use compared to those who wanted more children [33].…”