Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa

Abstract

Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants’ ( n = 360 men, n = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.

Factors associated with fertility intentions among women living with and without human immunodeficiency virus in Zambia

“…Our results are consistent with those of other related studies conducted in Malawi, Ethiopia and South Africa that found that fertility intentions among women reduced with age. 1 , 13 , 21 , 31 Furthermore, our findings also agree with earlier studies which observed that fertility intention reduced by 12.9% among women who had 2–3 children. 31 , 42 …”

“…Our results are consistent with those of other related studies conducted in Malawi, Ethiopia and South Africa that found that fertility intentions among women reduced with age. 1,13,21,31 Furthermore, our findings also agree with earlier studies which observed that fertility intention reduced by 12.9% among women who had 2-3 children. 31,42 Our study findings have also shown that mothers living without HIV in marital union had higher likelihood of fertility intentions compared to mothers who were never married.…”

“…18 Emerging evidence indicates that HIV status influences fertility intentions of women of reproductive age (15–49 years). 19 – 21 For instance, a study from Kenya found that fertility intentions among women living with HIV (WLWH) was 30% 20 while a study from Ethiopia revealed that 42% of WLWH wanted to have another child. 1 On the contrary, Zambia recorded a reduction in the proportion of women of reproductive age who wanted more children from 76% to 62% between 1992 and 2018.…”

Investigation of Participants’ Fertility Intentions under the “Three-Child” Policy in Guangxi Zhuang Autonomous Region, China

“…The research found that females' fertility intentions was significantly lower than males' (Shreffler et al, 2016) and males preferred their child to be a girl while females preferred boy (Dhande & Shingare, 2016). The fertility intention of rural residents was significantly higher than urban residents (Mandel et al, 2021). And high-income groups tended to have more children (Shreffler et al, 2016).…”

Effects of (In)Congruency in Fertility Motivation on Fertility Desire and Intention Among Couples Living with HIV: A Dyadic Approach

“…Indeed, factors such as increased dyadic motivation have been observed to in uence the reproductive intentions of couples in early ART among HIV-positive East Africans 18 . When a partner lacks a comparable motive to one's own, this disparity may be indicative of a negative fertility goal since it generates inconsistency and does not legitimize one's choice 19 . The incongruence of the partner's reproductive motive elicits and combats unpleasant feelings through this mechanism.…”