Womens Desire for Children in an HIV Population: A Clinical Pilot Study in Burkina Faso

Caroline, Lemoine; Nathalie, Willems; Diedon, Hien Alain; Karama, Robert; Idovide, Somda; Englert, Yvon

doi:10.2174/157016211797635973

Cited by 5 publications

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“…The only study we identified of HIV-infected African women with a level of childbearing intention similar to our findings was from Burkina Faso and reported as an intention proportion of 70% (Lemoine et al, 2011). The high proportion of childbearing intention among our HIV-infected participants may be related to the young age of our cohort.…”

Section: Discussionsupporting

confidence: 83%

“…While several studies have found younger age to be associated with increased childbearing intention (Asfaw and Gashe, 2014; Haddad et al, 2016; Kawale et al, 2014; Lemoine et al, 2011), some have identified increased age as a positive predictor of childbearing intention (Gyimah et al, 2015; Laar et al, 2015). A meta-analysis of fertility desires among HIV-infected men and women identified age less than 30 to be strongly associated with fertility intention (Berhan and Berhan, 2013).…”

Section: Discussionmentioning

confidence: 99%

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Water handling and low cost treatment practice of peoples living with human immunodeficiency virus (HIV) in Arba Minch Town, Southern Ethiopia, 2016

et al. 2017

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Women of reproductive age account for nearly half of all HIV-infected people worldwide. Childbearing intention among HIV-infected women is complicated by social and reproductive concerns related to their HIV status. We conducted a cross-sectional study of HIV-infected and HIV-uninfected sexually active South African women aged 17 to 21 in order to compare their childbearing intentions and to identify predictors of the desire to have children among women with HIV. We found the rate of childbearing intention to be similarly high among both HIV-infected and HIV-uninfected study participants (80 and 79% respectively, p=0.81). History of previous parity was found to be associated with decreased intention to have children. No difference in childbearing intention was found between HIV-infected women on anti-retroviral therapy (ART) and women not on ART. High rates of childbearing intention among HIV-infected women require integration of reproductive health services with comprehensive HIV/AIDS care in order to mitigate the risks of sexual and vertical transmission of HIV.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Water handling and low cost treatment practice of peoples living with human immunodeficiency virus (HIV) in Arba Minch Town, Southern Ethiopia, 2016

et al. 2017

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“…Age less than or equal to 35 years-old was associated with increased odds of desire for a child, and this age-related finding has been consistently documented (Caroline, et al, 2011; Taulo et al, 2009; Wagner, et al, 2012). Not yet having children was associated with increased odds of fertility desire, a finding well-supported by similar studies in the region (Kipp, et al, 2011; Schwartz, et al, 2012; Taulo, et al, 2009).…”

Section: Discussionmentioning

confidence: 75%

“…Research from sub-Saharan Africa suggests that the desire for children in the era of ART ranges from 45-75% (Caroline et al, 2011; Cooper et al, 2009; Schwartz et al, 2012). Despite data suggesting people with HIV desire children, most programs have focused on integrating contraception and ART delivery, but have not developed programs to specifically address fertility desires and safer conception.…”

Section: Introductionmentioning

confidence: 99%

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

Kawale

Mindry²,

Stramotas

et al. 2013

AIDS Care

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Improved health outcomes have resulted in people with HIV facing decisions about childbearing. We sought to understand factors associated with desire for a child among men and women in Malawi. HIV-infected men and women ages 18-40 were invited to participate in a brief interview about fertility desires. Single variable logistic regression was used to evaluate factors associated with the outcome of fertility desire. Additionally, multiple logistic regression was used to assess the relationship of all the factors together on the outcome of fertility desire. In-depth interviews with women were performed to understand experiences with reproductive healthcare. A total of 202 brief interviews were completed with 75 men (37.1%) and 127 women (62.9%), with 103 (51.0%) of respondents desiring a child. Being in a relationship (OR 3.48, 95% CI: 1.58 to 7.65, p = 0.002) and duration of HIV more than two years (OR 2.00, 95% CI: 1.08 to 3.67, p=0.03) were associated with increased odds of desire for a child. Age 36-40 years (OR 0.64, 95% CI: 0.46 to 0.90, p = 0.009) and having a living child (OR 0.24, 95% CI: 0.07 to 0.84, p=0.03) were associated with decreased odds of desire for a child. Seventy percent of women (n=19 of 27 respondents) completing semi-structured interviews who responded to the question about decision-making reported that their male partners made decisions about children, while the remainder reported the decision was collaborative (n=8, 30%). Eighty-six percent of women (n=36 of 42 respondents) reported no discussion or a discouraging discussion with a provider about having children. HIV-infected women and men in Malawi maintain a desire to have children. Interventions are needed to integrate safer conception into HIV care, to improve male participation in safer conception counseling, and to empower providers to help patients make decisions about reproduction free of discrimination and coercion.

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“…Malawi is no exception when it comes to the high value placed on motherhood even among women living with HIV. Findings of prior studies conducted in sub-Saharan Africa suggest that the desire to have children, especially since the advent of ART, ranges from 45 to 75% [ 16 , 17 ]. Several factors have been identified as influencing the women’s desire for pregnancy and childbearing.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the experience of sexual and reproductive healthcare for female adolescents with perinatally-acquired HIV: a qualitative case study

2017

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BackgroundYoung people living with perinatally-acquired HIV require age-appropriate support regarding sex and relationships as they progress towards adulthood. HIV affects both genders but evidence suggests that young women are particularly vulnerable to sexual abuse and more prone to engaging in sexual behaviours to meet their daily survival needs. This can result in poor sexual and reproductive health (SRH) outcomes. HIV services in Malawi provide support for young women’s HIV-related clinical needs, but it is unclear whether there is sufficient provision for their SRH needs as they become adults. This paper explores the sex and relationship experiences of young women growing up with perinatally-acquired HIV in order to understand how to improve SRH care and associated outcomes.MethodsA qualitative case study approach was adopted in which each ‘case’ comprised a young woman (15–19 years) with perinatally acquired HIV, a nominated caregiver and service provider. Participants were purposively selected from three multidisciplinary centres providing specialised paediatric/adolescent HIV care in Malawi. Data was collected for 14 cases through in-depth interviews (i.e. a total of 42 participants) and analysed using within-case and cross-case approaches. The interviews with adolescents were based on an innovative visual method known as ‘my story book’ which encouraged open discussion on sensitive topics.ResultsYoung women reported becoming sexually active at an early age for different reasons. Some sought a sense of intimacy, love, acceptance and belonging in these relationships, noting that they lacked this at home and/or within their peer groups. For others, their sexual activity was more functional – related to meeting survival needs. Young women reported having little control over negotiating safer sex or contraception. Their priority was preventing unwanted pregnancies yet several of the sample already had babies, and transfer to antenatal services created major disruptions in their HIV care. In contrast, caregivers and nurses regarded sexual activity from a clinical perspective, fearing onward transmission of HIV and advocating abstinence or condoms where possible. In addition, a cultural silence rooted in dominant religious and traditional norms closed down possibilities for discussion about sexual matters and prevented young women from accessing contraception.ConclusionThe study has shown how young women, caregivers and service providers have contrasting perspectives and priorities around SRH care. Illumination of these differences highlights a need for service improvement. It is suggested that young women themselves are involved in future service improvement initiatives to encourage the development of culturally and socially acceptable pathways of care.Electronic supplementary materialThe online version of this article (10.1186/s12905-017-0485-9) contains supplementary material, which is available to authorized users.

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Womens Desire for Children in an HIV Population: A Clinical Pilot Study in Burkina Faso

Cited by 5 publications

References 0 publications

Water handling and low cost treatment practice of peoples living with human immunodeficiency virus (HIV) in Arba Minch Town, Southern Ethiopia, 2016

Water handling and low cost treatment practice of peoples living with human immunodeficiency virus (HIV) in Arba Minch Town, Southern Ethiopia, 2016

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

Factors influencing the experience of sexual and reproductive healthcare for female adolescents with perinatally-acquired HIV: a qualitative case study

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