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Yao Y. Research on influencing factors of college teachers' second child fertility intentions--Taking Jinan as an example. PLoS One 2024; 19:e0299838. [PMID: 38771815 PMCID: PMC11108140 DOI: 10.1371/journal.pone.0299838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/16/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Fertility intentions, as a direct driver of fertility behavior, play an important role in the implementation of national fertility policy and population development. This study explored the influencing factors of college teachers' second child fertility intentions in Jinan, China on the basis of TPB. METHODOLOGY/PRINCIPAL FINDINGS Based on the theory of planned behavior, this paper employs basic characteristics analysis, difference analysis, and factor analysis related to the fertility intentions of the participants. Analysis found participants between 31 and 40 years old had the highest second child fertility intentions, and participants with a college-age first child had the lowest second child fertility intentions. Attitude and subjective norms had a positive impact on second child fertility intentions, and policy awareness had a positive impact on attitude, which indirectly affected second child fertility intentions. Subjective norms had the greatest influence on second child fertility intentions, followed by attitude, and policy awareness had the least influence on second child fertility intentions. SIGNIFICANCE/FUTURE RESEARCH The findings of this paper can enrich the theoretical research on fertility intentions, and also provide more optimal practical references for the formulation and propagation of China's fertility policy as well as the improvement of the division of family roles in China. Future research can further explore the impact of fertility policy on the fertility intentions of other groups.
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Affiliation(s)
- Yanling Yao
- School of Information Engineering, Shandong Management University, Jinan, Shandong, China
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Medley A, Tsiouris F, Pals S, Senyana B, Hanene S, Kayeye S, Casquete RR, Lasry A, Braaten M, Aholou T, Kasonde P, Chisenga T, Mweebo K, Harris TG. An Evaluation of an Enhanced Model of Integrating Family Planning Into HIV Treatment Services in Zambia, April 2018-June 2019. J Acquir Immune Defic Syndr 2023; 92:134-143. [PMID: 36240748 PMCID: PMC10913187 DOI: 10.1097/qai.0000000000003111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND We designed and implemented an enhanced model of integrating family planning (FP) into existing HIV treatment services at 6 health facilities in Lusaka, Zambia. METHODS The enhanced model included improving FP documentation within HIV monitoring systems, training HIV providers in FP services, offering contraceptives within the HIV clinic, and facilitated referral to community-based distributors. Independent samples of women living with HIV (WLHIV) aged ≥16 years were interviewed before and after intervention and their clinical data abstracted from medical charts. Logistic regression models were used to assess differences in key outcomes between the 2 periods. RESULTS A total of 629 WLHIV were interviewed preintervention and 684 postintervention. Current FP use increased from 35% to 49% comparing the pre- and postintervention periods ( P = 0.0025). Increased use was seen for injectables (15% vs. 25%, P < 0.0001) and implants (5% vs. 8%, P > 0.05) but not for pills (10% vs. 8%, P < 0.05) or intrauterine devices (1% vs. 1%, P > 0.05). Dual method use (contraceptive + barrier method) increased from 8% to 18% ( P = 0.0003), whereas unmet need for FP decreased from 59% to 46% ( P = 0.0003). Receipt of safer conception counseling increased from 27% to 39% ( P < 0.0001). The estimated total intervention cost was $83,293 (2018 USD). CONCLUSIONS Our model of FP/HIV integration significantly increased the number of WLHIV reporting current FP and dual method use, a met need for FP, and safer conception counseling. These results support continued efforts to integrate FP and HIV services to improve women's access to sexual and reproductive health services.
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Affiliation(s)
- Amy Medley
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Fatima Tsiouris
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Sherri Pals
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Brenda Senyana
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Susan Hanene
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Shadrick Kayeye
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | | | - Arielle Lasry
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Mollie Braaten
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Tiffiany Aholou
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Prisca Kasonde
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | | | - Keith Mweebo
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Lusaka, Zambia
| | - Tiffany G. Harris
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
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Zhu C, Yan L, Wang Y, Ji S, Zhang Y, Zhang J. Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China. Front Public Health 2022; 10:879672. [PMID: 35757654 PMCID: PMC9218102 DOI: 10.3389/fpubh.2022.879672] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/17/2022] [Indexed: 01/01/2023] Open
Abstract
Background and Purpose As the global fertility rate declines, China has issued two and three-child policies in the past 10 years. Therefore, this study serves to evaluate fertility intention rates and related factors in couples intending to have a second child and third child. Methods A cross-sectional survey was conducted in mainland China from July to August 2021. Couples with one or two children were invited to participate in our study in order to collect information about more than one child fertility intention and the possibly related factors. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors. Results Data was collected from a total of 1,026 couples. Among couples with one child, 130 (16.2%) couples had the intention to have a second child. Additionally, only 9.4% of couples with two children desired to have third child. The study revealed large differences in socioeconomic and personal factors between the two groups. For couples with intentions for a second-child, a female age >35 years (adjusted odds ratio, aOR 1.92), a first child's age range from 3 to 6 (aOR 3.12), annual child spending as a percentage of household income >30% (aOR 2.62), and children's educational barriers (aOR 1.55) were associated with lack of intent to have a second child. Similarly, among couples with two children, parents with family financial constraints (aOR 6.18) and children's educational barriers (aOR 4.93) are more likely to have lack of intent to have a third child. Here, we report that government policies encouraging fertility (aOR 0.04) can effectly promote couples to pursue a second or third child. Conclusion Overall, couples with one or two children in Shanghai had a low intention to give birth to a second or third child. In order to increase the birth rates, it is necessary to implement policies to reduce the burden of raising children and provide relief to parent's pressure of rearing a child with increased free time.
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Affiliation(s)
- Chenfeng Zhu
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Li Yan
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yang Wang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Sifan Ji
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yiqin Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Jian Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
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Woollett N, Pahad S, Black V. "We need our own clinics": Adolescents' living with HIV recommendations for a responsive health system. PLoS One 2021; 16:e0253984. [PMID: 34197529 PMCID: PMC8248739 DOI: 10.1371/journal.pone.0253984] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/16/2021] [Indexed: 02/02/2023] Open
Abstract
Adolescents living with HIV comprise a significant patient population in sub Saharan Africa but are poorly retained in care with consequent increased mortality and morbidity. We conducted in-depth interviews with 25 adolescents living with HIV engaged in care from five clinics in Johannesburg regarding their recommendations for the healthcare system. Findings included advocating for adolescent clinics, recognizing the importance of clinic-based support groups, valuing the influence lay counselors have in providing healthcare to adolescents, improving widespread education of vertical HIV transmission and meaningfully linking clinics to the community. Our study offers guidance to the differentiated care model recommended for adolescent treatment highlighting that a positive youth development approach and use of lay and peer counselors may act as cornerstones of this model. Serving the mental health needs of adolescents living with HIV in a responsive manner may strengthen their use of the system and elevate it to a source of resilience.
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Affiliation(s)
- Nataly Woollett
- Wits School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Shenaaz Pahad
- Wits Reproductive Health & HIV Institute (Wits RHI), Johannesburg, South Africa
| | - Vivian Black
- Department of Clinical Microbiology and Infectious Disease, Wits School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Rucinski KB, Powers KA, Pettifor AE, Black V, Pence BW, Chi BH, Rees H, Schwartz SR. Trajectories of fertility intentions among women living with HIV in South Africa. AIDS Care 2021; 33:180-186. [PMID: 32008361 PMCID: PMC7395884 DOI: 10.1080/09540121.2020.1719969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/24/2019] [Indexed: 10/25/2022]
Abstract
Fertility intentions are thought to be dynamic among women of reproductive age, yet few studies have assessed fertility intentions over time among women with HIV. We examine temporal patterns of fertility intentions in women with HIV to assess the extent to which fertility intentions - and the corresponding need for safer conception and judicious antiretroviral therapy (ART) regimen selection - vary over time. 850 non-pregnant HIV-positive women aged 18-35 on or being initiated onto ART in Johannesburg, South Africa were enrolled into a prospective cohort study (2009-2010). Fertility intentions were assessed at enrollment and at 30-day intervals via an interviewer-administered questionnaire. We used group-based trajectory modelling to identify longitudinal patterns of fertility intentions over 12 months. We identified four patterns of fertility intentions, which we labelled "consistently low" (representing ∼60% of the population), "low and increasing" (∼23%), "high and increasing" (∼12%), and "high and decreasing" (∼5%). Our findings suggest that a single family-planning assessment at one time point is insufficient to fully identify and meet the reproductive needs of women with HIV. As HIV testing and treatment evolve in South Africa, routine screening for fertility intentions can offer important opportunities to optimize HIV treatment, prevention, and maternal and child health.
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Affiliation(s)
- Katherine B Rucinski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Kimberly A Powers
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Audrey E Pettifor
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Vivian Black
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Benjamin H Chi
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Helen Rees
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheree R Schwartz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
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