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Assefa S, Dheresa M, Lami M, Berhanu B, Mohammed H, Sertsu A, Negash A, Balcha T, Eyeberu A, Debella A, Getachew T, Yadeta TA. Fertility desires of antiretroviral therapy-attending HIV-positive women and its associated factors in Harari region, Ethiopia. Int Health 2024; 16:174-181. [PMID: 37128936 PMCID: PMC10911533 DOI: 10.1093/inthealth/ihad030] [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: 01/26/2023] [Revised: 03/01/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia. METHODS A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV - positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared. RESULTS A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire. CONCLUSION The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.
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Affiliation(s)
- Sirgut Assefa
- Higher clinic, P.O. box: 235, Haramaya University, Harar town, Harari, Ethiopia
| | - Merga Dheresa
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Magarsa Lami
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Bekelu Berhanu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Hanan Mohammed
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Addisu Sertsu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Abraham Negash
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tegenu Balcha
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Addis Eyeberu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Adera Debella
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tamirat Getachew
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tesfaye Assebe Yadeta
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
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Mugabi B, Nanyingi M, Kabanda R, Ndibazza J, Elyanu P, Asiimwe JB, Nazziwa G, Habaasa G, Kekitiinwa A. Prevalence and factors associated with sexual and reproductive health literacy among youth living with HIV in Uganda: a cross-sectional study. BMC Public Health 2023; 23:1497. [PMID: 37550680 PMCID: PMC10405416 DOI: 10.1186/s12889-023-16399-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Adequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodeficiency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda. METHODS Through a cross-sectional survey, YLHIV receiving routine HIV care services at Baylor-Uganda HIV Clinic were interviewed using an adapted European Health Literacy Survey (HLS-EU). Using simple random sampling, eligible youth who received HIV care services between August and November 2019 were enrolled in the study. SRHL scores were computed using the HLS-EU index method; and individuals whose scores ranged from 34 to 50 were considered health literate. We used descriptive statistics to determine the prevalence. Potential associated personal and environmental factors (p<0.05) were identified by performing two-step inferential statistics, bivariate analysis and binary logistic regression. Odds ratios were calculated to estimate the likelihood of youth being health literate on sexual and reproductive health (SRH) issues in comparison with the reference categories, and 95% confidence intervals were determined to establish whether the relationships were statistically significant. RESULTS Of the 267 YLHIV interviewed at Baylor-Uganda HIV Clinic, 167 (62.5%) were female with a mean age of 18.9 years (SD± 2.8), and the majority (242; 90.6%) were vertically infected with HIV. Only 52 (19.5%) were health literate on SRH issues. At the multivariate level, YLHIV who never had difficulty accessing SRH information were 0.391 times less likely to be health literate on SRH issues than their counterparts with challenges in accessing SRH information (Adjusted Odds Ratio [AOR] = 0.391, 95% CI =0.178 to 0.860; p= 0.019). YLHIV who did not find it easy to access SRH care service points were 2.929 times more likely to be literate in SRH than those who found it easy to access such services (Adjusted Odds Ratio [AOR] = 2.929, 95% CI =1.241 to 6.917; p=0.014). Additionally, YLHIV who did not listen to radio health talks were 2.406 times more likely to be health literate on SRH issues than those who did (AOR = 2.406, 95% CI =1.133 to 5.112; p=0.022). CONCLUSIONS SRHL is an unmet need among YLHIV; only 19.5% were health literate on SRH issues. This could complicate the achievement of the UNAIDS sustainable development goal (SDG) of an HIV/AIDS-free generation by 2030 because low health literacy (HL) skills can affect the efficacy of almost all HIV disease prevention and health promotion efforts. Inaccessible SRH care service points and not listening to radio health talks were positively associated with SRHL, while having access to SRH information was negatively associated with SRHL.
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Affiliation(s)
| | | | | | | | - Peter Elyanu
- Baylor College of Medicine Children's Foundation Uganda, PO Box 72052, Kampala, Uganda
| | | | | | - Gilbert Habaasa
- Population and Development Consult Limited, PO Box 23746, Kampala, Uganda
| | - Adeodata Kekitiinwa
- Baylor College of Medicine Children's Foundation Uganda, PO Box 72052, Kampala, Uganda
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Mulemena D, Phiri M, Mutombo N, Lukama C, Odhiambo JN, Kalinda C. Factors associated with fertility intentions among women living with and without human immunodeficiency virus in Zambia. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231219600. [PMID: 38130101 DOI: 10.1177/17455057231219600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Zambia is one of the countries in sub-Saharan Africa with a high prevalence of human immunodeficiency virus among women of reproductive age. Notably, the literature shows that human immunodeficiency virus status is one of the factors that influence fertility intention among women of reproductive age. With increased access, uptake and coverage of anti retroviral therapy, there is a need to understand the influence of human immunodeficiency virus status on fertility intentions of women of reproductive age in Zambia. OBJECTIVES The purpose of this study was to determine the fertility intentions of both mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus in Zambia. DESIGN This study adopted a cross-sectional design using data collected by the Zambia Demographic and Health Survey conducted in 2018. The study sample comprised 7983 mothers in the reproductive age (15-49 years), of which 6704 were mothers living without human immunodeficiency virus and 1279 were mothers living with human immunodeficiency virus. METHODS Here, we determined the fertility intentions of mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus using secondary data. Multivariable logistic regression models were used to determine the association of individual and household socio-demographic factors on fertility intentions of mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus in Zambia. RESULTS Fertility intention among mothers living with human immunodeficiency virus was 42.1% while that on mothers living without human immunodeficiency virus was 55.5%. Regardless of human immunodeficiency virus status, fertility intention reduced with increasing age. Mothers aged 35-49 years who were living with human immunodeficiency virus (adjusted odds ratio = 0.12, 95% confidence interval = 0.06-0.24) and mothers aged 35-49 years who were living without human immunodeficiency virus (adjusted odds ratio = 0.18, 95% confidence interval = 0.13-0.26) had lower odds of intention to have another child compared to mothers aged 15-24 years. Furthermore, married mothers living with human immunodeficiency virus and those living without human immunodeficiency virus had increased odds of intention of having another child (adjusted odds ratio = 2.52, 95% confidence interval = 1.36-4.66) and (adjusted odds ratio = 3.21, 95% confidence interval = 2.36-4.36), respectively. CONCLUSION The study has established that age, marital status, parity and employment status were associated with fertility intention among women living with and without human immunodeficiency virus. The results necessitate the need for enhanced maternal health education for mothers regardless of human immunodeficiency virus status. Furthermore, there is a need for continuous counselling for both women living with human immunodeficiency virus and without human immunodeficiency virus during their routine human immunodeficiency virus care, to improve and enhance pregnancy outcomes.
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Affiliation(s)
- David Mulemena
- USAID Zambia Accessible Markets for Health, John Snow Inc, Research and Training Institute (JSI, INC), Lusaka, Zambia
| | - Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - Namuunda Mutombo
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Chinyama Lukama
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | | | - Chester Kalinda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
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Mkwashapi D, Todd J, Mahande M, Changalucha J, Urassa M, Marston M, Renju J. No association between fertility desire and HIV infections among men and women: Findings from community-based studies before and after implementation of an early antiretroviral therapy (ART) initiation program in the rural district of North-western Tanzania. OPEN RESEARCH AFRICA 2022; 5:30. [PMID: 37600565 PMCID: PMC10432893 DOI: 10.12688/openresafrica.13432.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 08/22/2023]
Abstract
Background: Fertility is associated with the desire to have children. The impacts of HIV and antiretroviral therapy (ART) on fertility are well known, but their impacts on the desire for children are less well known in Tanzania. We used data from two studies carried out at different periods of ART coverage in rural Tanzania to explore the relationship between HIV infection and fertility desires in men and women. Methods: We conducted secondary data analysis of the two community-based studies conducted in 2012 and 2017 in the Magu Health and Demographic system site, in Tanzania. Information on fertility desires, HIV status, and social-economic and demographic variables were analyzed. Fertility desire was defined as whether or not the participant wanted to bear a child in the next two years. The main analysis used log-binomial regression to assess the association between fertility desire and HIV infection. Results: In the 2012 study, 43% (95% CI 40.7-45.3) of men and 33.3% (95% CI 31.8 - 35.0) women wanted another child in the next two years. In 2017 the percentage rose to 55.7% (95% CI 53.6 - 57.8) in men and 41.5% (95% CI 39.8 - 43.1) in women. Although fertility desire in men and women were higher in HIV uninfected compared to HIV infected, age-adjusted analysis did not show a statistical significance difference in both studies (2012: PR=1.02, 95%CI 0.835 - 1.174, p<0.915 and 2017: PR = 0.90 95%CI 0.743 - 1.084 p= 0.262). Discussion: One-third of women and forty percent of men desired for fertility in 2012, while forty percent of women and nearly half of men desired for fertility in 2017. The data showed fertility desire, in 2012 and 2017 were not related to HIV infection in both periods of ART coverage.
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Affiliation(s)
- Denna Mkwashapi
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Jim Todd
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom, UK
| | - Michael Mahande
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania, Tanzania
| | - John Changalucha
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Mark Urassa
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Milly Marston
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom, UK
| | - Jenny Renju
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania, Tanzania
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Eniyew MA, Haji Y, Abebe K, Demelash M, Mesfin Y, Embiale A, Amare B. Fertility desire and associated factors among people on antiretroviral treatment at a public health facility in Hawassa city, Southern Ethiopia. Afr Health Sci 2022; 22:24-33. [PMID: 36910367 PMCID: PMC9993251 DOI: 10.4314/ahs.v22i3.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Fertility desire is the plan of people to have a child or more children in the face of being diagnosed with HIV and plan to a commitment to implement the desire. Methods An institutional-based cross-sectional study was conducted in Hawassa city public health facilities from May 09 -July 07/07/2019. Four hundred (400) study participants were selected using a simple random sampling technique. Data were collected by using interviewer-administered pre-tested structured questionnaires and chart review. The collected data were entered into EPI data version 3.1 software and then transported to SPSS version 20 for cleaning and data analysis. Bivariate and multivariate logistic regression was used to identify associated factors at p<0.05 was taken as a significant value with a 95% confidence level. Results A total of 400 clients were included in the study giving a response rate of 97 %. The overall fertility desire was 53.6 %(95%CI: 48.7%, 58.2%). Age, sexual practice in the last six months and discussing reproductive health with ART providers were significantly associated with fertility desire. Younger age was positively associated with fertility desire, age group (18-29), [Adjust odds ratio = 5.75 95%CI (2.85, 11.57)] , age group(30-39), [Adjust odds ratio= 4.71 95%CI:(2.55, 8.71)] Sexual practice in the last six months [Adjust odds ratio = 3.00 95%CI(1.46 , 6.16)] and counseling reproductive health with ART provider[Adjust odds ratio = 3.10 95%CI:(1.86,5.15)]. Conclusion The prevalence of fertility desire in this study was higher than previous studies while factors associated with fertility desire were age, sexual practice in the last six months, and discussing reproductive health with ART providers.
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Affiliation(s)
- Muche Argaw Eniyew
- Department of Midwifery, College of medicine and health sciences, Wolkite University, Wolkite, Ethiopia
| | - Yusuf Haji
- Department of Public health, College of medicine and health sciences, Hawassa University, Hawassa, Ethiopia
| | - Kelemu Abebe
- Department of Midwifery, College of medicine and health sciences, Woliata sodo University, Woliata, Ethiopia
| | - Minchil Demelash
- Department of Midwifery, College of medicine and health sciences, Wachamo University, Wachamo, Ethiopia
| | - Yibeltal Mesfin
- Department of Midwifery, College of medicine and health sciences, Wolkite University, Wolkite Ethiopia
| | - Aynamaw Embiale
- Department of Midwifery, College of medicine and health sciences, Madda Walabu University, Madda Walabu, Ethiopia
| | - Belay Amare
- Department of Midwifery, College of medicine and health sciences, Hawassa University, Hawassa, Ethiopia
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Balis B, Assefa N, Egata G, Bekele H, Getachew T, Ayana GM, Raru TB, Taye Merga B. Knowledge about vertical transmission of HIV and associated factors among women living with HIV or AIDS attending antiretroviral therapy clinic, Western Ethiopia. WOMEN'S HEALTH 2022; 18:17455065211070675. [PMID: 35001747 PMCID: PMC8744184 DOI: 10.1177/17455065211070675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The United Nations Program on HIV or AIDS has committed to eliminating the
vertical transmission of human immunodeficiency virus. However, significant
number of newborn and children are acquiring HIV every year. Therefore, the
aim of this study was to assess knowledge of mother on vertical transmission
of HIV and associated factors among non-pregnant women receiving
antiretroviral therapy in the West Wollega, Western Ethiopia. Methods: A facility-based cross-sectional study design was used on a sample of 422
non-pregnant women attending antiretroviral therapy clinic in West Wollega
from 26 February to 26 March 2019. Systematic sampling was used to select
the study participants. Pretested and structured interviewer-administered
questionnaires and telephone interview were used to collect the data.
Multivariable logistic regression model was used to identify factors
associated with the knowledge of mother on vertical transmission of HIV.
Odds ratio along with 95% confidence interval were estimated to measure the
strength of the association. Level of statistical significance was declared
at p-value less than 0.05. Result: Out of total participants, 94.1% (95% confidence interval: (91.7%, 96.2%)) of
them were knowledgeable about vertical transmission of HIV. Urban resident
(adjusted odds ratio: 2.36, 95% confidence interval: (1.27, 4.39)), primary
school (adjusted odds ratio: 2.94, 95% confidence interval: (1.11, 7.83)),
secondary school (adjusted odds ratio: 3.39, 95% confidence interval: (1.53,
7.55)), being on antiretroviral therapy for greater than 2 years (adjusted
odds ratio: 2.67, 95% confidence interval: 1.02, 6.99)), and having child
living with HIV (adjusted odds ratio: 1.54, 95% confidence interval: (1.07,
3 .83)) were significantly associated with the knowledge of mother on
vertical transmission of HIV. Conclusion: The study indicated that 5.9% of the women lack knowledge about vertical
transmission of HIV. This knowledge associated with sociodemographic
factors, such as residence, educational status, experiences of having child
living with HIV, and being on antiretroviral therapy for greater than
2 years. Thus, interventions toward the elimination of new newborn HIV
infections should consider these factors.
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Affiliation(s)
- Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health and Medical Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Mandell LN, Rodriguez VJ, Peltzer K, Weiss SM, Jones DL. Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa. Int J STD AIDS 2021; 32:740-750. [PMID: 33769899 DOI: 10.1177/0956462420987447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Lissa N Mandell
- Department of Psychiatry and Behavioral Sciences, 5452University of Miami Miller School of Medicine, Miami, FL, USA
| | - Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, 5452University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Psychology, University of Georgia, Athens, GA, USA
| | - Karl Peltzer
- HIV/AIDS/STIs and TB (HAST) Research Programme, 56867Human Sciences Research Council, Pretoria, South Africa.,Department of Research & Innovation, 37714University of Limpopo, Sovenga, South Africa
| | - Stephen M Weiss
- Department of Psychiatry and Behavioral Sciences, 5452University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, 5452University of Miami Miller School of Medicine, Miami, FL, USA
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Prevalence and factors associated with fertility desire among people living with HIV: A systematic review and meta-analysis. PLoS One 2021; 16:e0248872. [PMID: 33735265 PMCID: PMC7971888 DOI: 10.1371/journal.pone.0248872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 03/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The fertility desire of people living with HIV (PLHIV) has been rising in the past decade. However, there are many studies among which the association remains controversial between the fertility desire of HIV-infected persons and antiretroviral therapy (ART), sex, marital status, and educational level. METHODS We performed a literature search of these meta-analyses in PubMed, the Cochrane Library, Web of Science and ScienceDirect in November 2019. We also reviewed references of eligible studies to complement the search. We used pooled odds ratios (ORs) and 95% confidence intervals (CIs) with a random-effects model and a fixed-effects model to estimate the association between fertility desire among PLHIV and ART, sex, age, marital status, educational level, and number of children. Subgroups with I square values (I2) and sensitivity analyses were performed to assess the heterogeneity and the stability of the overall ORs, respectively. We evaluated publication bias using Egger's test and a visual inspection of the symmetry in funnel plots. RESULTS In these meta-analyses 50 articles were included with 22,367 subjects. The pooled prevalence of fertility desire among PLHIV was estimated to be 42.04%. The pooled analyses showed that the fertility desire of PLHIV is associated with ART (OR = 1.11, 95% CI:1.00-1.23, P = 0.043), sex (OR = 1.51, 95% CI:1.10-2.09), age (OR = 2.65, 95% CI:2.24-3.14), marital status (OR = 1.34, 95% CI:1.08-1.66), educational level (OR = 0.85, 95% CI:0.73-1.00, P = 0.047) and the number of children (OR = 3.99, 95% CI:3.06-5.20). PLHIV who are on ART, are male, are younger than 30, are married/cohabiting, have received a secondary education or above, and are childless have a higher prevalence of fertility desire. The two factors of age and the number of children, in particular demonstrated a strong significant association with fertility desire. We found moderate heterogeneity in the meta-analyses of age and educational level and high heterogeneity in the meta-analyses of sex, marital status and number of children. Publication bias was detected in the meta-analyses of the association of fertility with sex and educational level. CONCLUSION This study demonstrates that the prevalence of fertility desire among HIV-infected people is 42.04%, and the fertility desire among PLHIV is associated with ART experience, sex, age, marital status, the number of children, and educational level. Since a majority of PLHIV are of reproductive age, it is necessary to support PLHIV in terms of their needs regarding reproductive decision-making. Through counseling and reproductive health care, further measures to prevent the horizontal and vertical transmission of HIV should be taken.
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Chirambira P, Madiba S, Ntuli B. Societal and individual drivers of fertility desires and intentions among people living with HIV: a cross sectional study of HIV clinic attendees in Soweto, South Africa. AIMS Public Health 2021; 9:173-184. [PMID: 35071676 PMCID: PMC8755963 DOI: 10.3934/publichealth.2022013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background High proportion of people living with HIV (PLHIV) who are in the prime of their reproductive years desire to have children. There are limited studies that explore the range of fertility intentions for PLHIV. This study investigated the fertility desires and intentions of PLHIV and the associated factors. Methods This was a cross-sectional study of 442 PLHIV receiving antiretroviral treatment (ART) in health facilities in Soweto, an urban township that is situated in the City of Johannesburg in South Africa. STATA version 13 was used to analyze the data. Results The participants' mean age was 36.3 years, 70% were females, 79.6% had at least one biological child, and 36% had 3+ children. Almost half (47%) expressed the desire for children, saying that this was because they had no biological children, or their partners wanted children, or they wanted children of a particular sex, or were feeling healthy after taking ART. An increased fertility desire was associated with absence of biological children (AOR = 5.06, 95% CI: 2.11–12.1) and with being married (AOR = 2.63, 95% CI: 1.31–5.27). A decreased fertility desire was associated with being aged 36+ (AOR = 2.63, 95% CI: 1.31–5.27), having primary education (AOR = 0.11, 95% CI: 0.01–1.30) and having ≥4 years of ART duration (AOR = 0.45, 95% CI: 0.24–0.81). Conclusion Individual factors played a significant role in shaping the fertility desires of PLHIV in this setting. The high desire for children underscore the need to integrate reproductive health services in HIV and AIDS care and treatment services and develop safer conception programmes to help PLHIV to conceive and have children safely.
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Balis B. Risky Sexual Practice and Associated Factors Among Women Living with HIV/AIDS Receiving Antiretroviral Therapy at a PMTCT Clinic in Western Oromia, Ethiopia. HIV AIDS (Auckl) 2020; 12:739-747. [PMID: 33235515 PMCID: PMC7678463 DOI: 10.2147/hiv.s258740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/21/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus infection has been one of the top health-related challenges for the past four decades. Ethiopia is extremely infected by HIV pandemic every year, whereby 22,300 people were newly infected and 690,000 were living with HIV at the end of 2018. Sexual behavior of HIV positive individuals visiting treatment clinics is a neglected issue. Nonetheless, it has been a significant way of HIV transmission to serodiscordant partners. METHODS A facility-based cross-sectional study design was used on a sample of 432 women attending treatment clinics in west Oromia from February 26 to March 26, 2019. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaires were used to collect the data. The data were coded, entered, cleaned and exported to SPSS version 20.0 for analysis. Descriptive statistics were used to present frequency distributions. Variables with P-value <0.25 during bivariate analysis were entered into multiple logistic regression models to control for all possible confounders. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at a p-value less than 0.05. RESULTS Out of total respondents, 240 (56.9%), 95% CI: (52.1-61.6%) were involved in risky sexual practices in the prior 12 months. Urban residence [AOR: 3.24, (95% CI: (1.52, 6.89)], those with no formal education [AOR: 2.77, (95% CI: (1.18, 6.54)], being on ART for >2years [AOR: 2.74, (95% CI: (1.13, 6.65)] and CD4 count ≥200 cells/mm3 [AOR: 3.20, (95% CI: (1.50, 6.82)] were factors significantly associated with risky sexual practice. CONCLUSION A considerable number of respondents were involved in risky sexual practices 240 (56.9%) due to being rural residence, not attending formal education, being on ART for >2 years and CD4 count ≥200 cells/mm3.
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Affiliation(s)
- Bikila Balis
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Western Oromia, Ethiopia
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11
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Hughes CS, Brown J, Murombedzi C, Chirenda T, Chareka G, Mhlanga F, Mateveke B, Gitome S, Makurumure T, Matubu A, Mgodi N, Chirenje Z, Kahn JG. Estimated costs for the delivery of safer conception strategies for HIV-discordant couples in Zimbabwe: a cost analysis. BMC Health Serv Res 2020; 20:940. [PMID: 33046066 PMCID: PMC7552466 DOI: 10.1186/s12913-020-05784-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, safer conception strategies have been developed to help HIV-serodiscordant couples conceive a child without transmitting HIV to the seronegative partner. The SAFER clinical trial assessed implementation of these strategies in Zimbabwe. METHODS As a part of the SAFER study, we estimated the costs (in 2017 $US) associated with individual and combination strategies, in the trial setting and real-world practice, from a healthcare system perspective. Safer conception strategies included: 1) ART with frequent viral load testing until achieving undetectable viral load (ART-VL); 2) daily oral pre-exposure prophylaxis (PrEP); 3) semen-washing with intrauterine insemination; and 4) manual self-insemination at home. For costs in the trial, we used a micro-costing approach, including a time and motion study to quantify personnel effort, and estimated the cost per couple for individual and combination strategies for a mean of 6 months of safer services. For real-world practice, we modeled costs for three implementation scenarios, representing differences from the trial in input prices (paid by the Ministry of Health and Child Care [MOHCC]), intervention intensity, and increments to current HIV prevention and treatment practices and guidelines. We used one-way sensitivity analyses to assess the impact of uncertainty in input variables. RESULTS Individual strategy costs were $769-$1615 per couple in the trial; $185-$563 if using MOHCC prices. Under the target intervention intensity and using MOHCC prices, individual strategy costs were $73-$360 per couple over and above the cost of current HIV clinical practices. The cost of delivering the most commonly selected combination, ART-VL plus PrEP, ranged from $166-$517 per couple under the three real-world scenarios. Highest costs were for personnel, lab tests, and strategy-specific consumables, in variable proportions by clinical strategy and analysis scenario. Total costs were most affected by uncertainty in the price of PrEP, number of semen-washing attempts, and scale-up of semen-washing capacity. CONCLUSIONS Safer conception methods have costs that may be affordable in many low-resource settings. These cost data will help implementers and policymakers add safer conception services. Cost-effectiveness analysis is needed to assess value for money for safer conception services overall and for safer strategy combinations. TRIAL REGISTRATION Registry Name: Clinicaltrials.gov. TRIAL REGISTRATION NUMBER NCT03049176 . Registration date: February 9, 2017.
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Affiliation(s)
- Carolyn Smith Hughes
- Institute for Global Health Sciences, University of California, 550 16th Street, 3rd Floor, San Francisco, 94158, USA.
| | - Joelle Brown
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Caroline Murombedzi
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Thandiwe Chirenda
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Gift Chareka
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Felix Mhlanga
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | | | - Serah Gitome
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Allen Matubu
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Nyaradzo Mgodi
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Zvavahera Chirenje
- College of Health Sciences Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - James G Kahn
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, USA
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Aylie NS, Dadi LS, Alemayehu E, Mekonn MA. Determinants of Fertility Desire among Women Living with HIV in the Childbearing Age Attending Antiretroviral Therapy Clinic at Jimma University Medical Center, Southwest Ethiopia: A Facility-Based Case-Control Study. Int J Reprod Med 2020; 2020:6504567. [PMID: 32851055 PMCID: PMC7441441 DOI: 10.1155/2020/6504567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/23/2020] [Accepted: 07/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND High fertility and aspiration to have more children are a normal phenomenon in many developing countries including Ethiopia. The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Despite the growing number of women living with HIV/AIDS, the issues of fertility and childbearing intention have not been widely studied in Ethiopia. OBJECTIVE To identify determinants of fertility desire among women living with HIV in the childbearing age attending antiretroviral therapy clinic at Jimma University Medical Center, Southwest Ethiopia. METHODS A facility-based case-control study was conducted in March 2019. Cases were women living with HIV who had fertility desire, and controls were those who had not. Data was collected using a face-to-face interview using a pretested questionnaire. The data was entered into EpiData 3.1 and exported to SPSS Version 24 for analysis. Bivariate and multivariable logistic regression analyses were used to identify candidate and independent determinants of fertility desire, respectively. Independent determinants associated with fertility desire were assessed using AORs with their corresponding 95% CIs at P value < 0.05 cutoff point. Results. Three hundred forty-four (115 cases and 229 controls) were included into the study with a 100% response rate. Age categories 15-24 (AOR: 4.1; 95% CI: 2.0, 8.4) and 25-34 (AOR: 2.3; 95% CI: 1.3, 4.2) years, not using family planning (AOR: 2.3; 95% CI: 1.4, 4.0), and having a sexual partner (AOR: 1.9; 95% CI: 1.1, 3.2) were independent predictors of fertility desire. CONCLUSIONS Age of women, family planning, and sexual partner were found to be the independent predictors of fertility desire among women living with HIV/AIDS. Policymakers and health care providers who are working on an ART clinic should try to consider the effects of these factors for women living with HIV while developing HIV/AIDS interventions and discussing on sexual and reproductive health issues with their clients, respectively.
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Affiliation(s)
- Nigusie Shifera Aylie
- Nursing Department, College of Health Science Mizan-Tepi Unversity, Mizan-Aman, Ethiopia
| | - Lelisa Sena Dadi
- Epidemiology Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Epidemiology Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Mengistu Ayenew Mekonn
- Epidemiology Department, College of Health Science Mizan-Tepi Unversity, Mizan-Aman, Ethiopia
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Yam EA, Kahabuka C, Mbita G, Winani K, Apicella L, Casalini C, Mbuguni Z. Safer conception for female sex workers living with HIV in Dar es Salaam, Tanzania: Cross-sectional analysis of needs and opportunities in integrated family planning/HIV services. PLoS One 2020; 15:e0235739. [PMID: 32692777 PMCID: PMC7373272 DOI: 10.1371/journal.pone.0235739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 06/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background With the advent of effective treatment, women living with HIV can plan for pregnancy while minimizing risk of transmission to infants and seronegative partners. Family planning (FP) services tend to focus solely on addressing contraceptive need, but HIV-positive women—including female sex workers—often plan to have children someday. Various “safer conception” strategies are now available to support women living with HIV achieve fertility intentions, and integrated HIV/FP services may be a promising platform to offer these services. Methods At integrated community-based HIV/FP service delivery sites operated by Jhpiego’s Sauti project in Dar es Salaam, we conducted exit interviews with 300 HIV-positive female sex workers. Descriptive analyses were conducted to describe their desire for children, use of condoms and other modern contraceptive methods, self-reported viral suppression, and knowledge of and interest in safer conception strategies. We conducted bivariate and multivariate logistic regression analysis to examine correlates of fertility desire among respondents. Results Median age of participants was 32. Nearly one-third wished to have a child within two years. Seventy-two percent had heard of having the HIV-positive partner taking ART to reduce sexual transmission during pregnancy attempts. Thirty-one percent felt the amount of FP content covered in the consultation was “too little.” Factors significantly associated with desire for children were having a nonpaying partner (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI]1.13–4.20) and having fewer children (AOR 0.65, 95% CI 0.48–0.87). Viral suppression was not associated with fertility desire. Conclusions Sex workers living with HIV attending integrated HIV/FP services have need for both contraception as well as safer conception counseling. This integrated service delivery modality is a promising platform for providing safer conception services. FP counseling for HIV-positive women should be broadened to broach the topic of safer pregnancy, as well as explicit counseling on strategies to minimize risk of sexual transmission to partners.
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Affiliation(s)
- Eileen A. Yam
- Population Council, Washington, DC, United States of America
- * E-mail:
| | | | | | - Koheleth Winani
- Reproductive and Child Health Section, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | | | | | - Zuhura Mbuguni
- Reproductive and Child Health Section, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
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Pollard R, Saleem H. Reproductive identities following an HIV diagnosis: strategies in the face of biographical disruption. CULTURE, HEALTH & SEXUALITY 2020; 22:385-397. [PMID: 31012809 DOI: 10.1080/13691058.2019.1603399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
This study explores how living with HIV affects fertility desires and reproductive identities in a context where HIV is highly stigmatised and parenthood is highly valued. We conducted interviews with 30 women and 30 men living with HIV, and 30 health care providers in Iringa, Tanzania. Using the conceptual framework of biographical disruption, we analysed interviews to characterise strategies participants living with HIV employed to regain a sense of normalcy. We found that living with HIV had consequences that disrupted notions of reproductive identity and that these disruptions influenced fertility desires and safer conception planning of both women and men living with HIV. Some participants relinquished the desire for children altogether, while others maintained the role of procreator as a strategy to conceal their HIV status and maintain their value in society. Perceptions of normalcy and notions of reproductive identity following an HIV diagnosis shape how people living with HIV navigate fertility decision-making in the face of biographical disruption. Findings can inform HIV programming to help those living with HIV regain a sense of normalcy by fostering solidarity, reducing community-based stigma and promoting safer conception for those who desire children and effective contraception for those who do not.
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Affiliation(s)
- Rose Pollard
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MA, USA
| | - Haneefa Saleem
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MA, USA
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Zewdie Z, Yitayal M, Kebede Y, Gebeyehu A. Status of family planning integration to HIV care in Amhara regional state, Ethiopia. BMC Pregnancy Childbirth 2020; 20:145. [PMID: 32143596 PMCID: PMC7059673 DOI: 10.1186/s12884-020-2838-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use. METHODS A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use. RESULTS A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24-0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10-0.37) and women in the age group of 25-34 years (AOR 0.42, 95% CI = 0.20-0.88) and 35-49 years (AOR 0.41, 95% CI = 0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes. CONCLUSION This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.
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Affiliation(s)
- Zebideru Zewdie
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,Ethiopian Federal Ministry of Health, P.O. Box: 1234, Addis Ababa, Ethiopia.
| | - Mezgebu Yitayal
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebaw Gebeyehu
- Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia
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16
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Kyaw KWY, Mon AA, Phyo KH, Kyaw NTT, Kumar AMV, Lwin TT, Aung ZZ, Aung TK, Oo MM, Htun T, Ya SST, Satyanarayana S, Oo HN. Initiation of antiretroviral therapy or antiretroviral prophylaxis in pregnant women living with HIV registered in five townships of Mandalay, Myanmar: A cross sectional study. BMC Pregnancy Childbirth 2019; 19:475. [PMID: 31805892 PMCID: PMC6896496 DOI: 10.1186/s12884-019-2627-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 11/22/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A series of interventions are required to prevent mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) starting from HIV testing of pregnant women, initiating antiretroviral therapy (ART) or antiretroviral prophylaxis to HIV-positive pregnant women to providing HIV prophylaxis to newborn babies. Gaps in each step can significantly affect the effectiveness of PMTCT interventions. We aimed to determine the gap in initiation of ART/antiretroviral prophylaxis for pregnant women living with HIV, delay in initiation of ART/antiretroviral prophylaxis and factors associated with the delay. METHODS This is a cross sectional study using routinely collected programme data from five health facilities providing PMTCT services located at Township Health Departments (THD) of Mandalay, Myanmar. RESULTS There were 363 pregnant women living with HIV enrolled between January 2012 and December 2017. Sixty (16%) women were excluded from the study due to missing data on dates of HIV diagnosis. Of 303 (84%) women included in the study, 89/303 (29%) and 214/303 (71%) were diagnosed with HIV before and during current pregnancy respectively. Among 214 women, 180 (84%) women were started on ART by the censor date (31st March 2018). Among those who started ART, 109 (61%) women had a delay of starting ART > 2 weeks from diagnosis. Women residing in township 4 had a significantly higher risk of delay in initiation of ART/antiretroviral prophylaxis compared to women residing in township 1 [adjusted prevalence ratio 4.2 (95% confidence interval 1.2-14.8]. CONCLUSIONS We found that one in four women living with HIV knew their HIV status before current pregnancy. Although the rate of ART/antiretroviral prophylaxis initiation was high among pregnant women living with HIV, there was a delay. Early initiation of ART/antiretroviral prophylaxis among newly HIV diagnosed pregnant women needs to be strengthened.
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Affiliation(s)
- Khine Wut Yee Kyaw
- Department of Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Aye Aye Mon
- HIV unit, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Khaing Hnin Phyo
- HIV unit, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Nang Thu Thu Kyaw
- Department of Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
- Center for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - Ajay M. V. Kumar
- Center for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
- Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, India
| | - Than Than Lwin
- National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Zaw Zaw Aung
- National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thet Ko Aung
- HIV unit, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Myo Minn Oo
- Department of Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Thurain Htun
- Monitoring, Evaluation, Accountability and Learning Unit (HIV), International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Sai Soe Thu Ya
- Monitoring, Evaluation, Accountability and Learning Unit (HIV), International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar
| | - Srinath Satyanarayana
- Center for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - Htun Nyunt Oo
- National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
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Pottinger AM, Carroll K. Reproductive needs of PLHIV in Jamaica: relationship between fertility desire, motives and depression. J Reprod Infant Psychol 2019; 38:38-48. [PMID: 30939927 DOI: 10.1080/02646838.2019.1599334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background/objective: Advances in antiretroviral therapy and assisted reproduction technology which allow for longer and healthier lives and safer conception options necessitate a new understanding of the sexual and reproductive needs of persons living with HIV (PLHIV). This study examines fertility desire and motives for having children among PLHIV in Jamaica and explores the association with depressive symptoms.Methods: In a cross-sectional study, 251 PLHIV in their reproductive years voluntarily completed an interviewer-administered questionnaire. SPSS analyses involved bivariate and logistic regression models significant at p < .05.Results: A desire to have children was expressed by 66% (n = 166), mostly males and persons younger than 40 years. Of those in a current relationship (n = 126), not having previous children best predicted fertility desire (p = .001; CI 0.04-0.44) as well as motives to conceive (p = .02; CI 0.01-0.66). PLHIVs in their reproductive years who are at depression risk are those in a sero-discordant relationship (p = .01; CI 1.48-30.22) and who have been diagnosed between 1 and 4 years (p = .05; CI 0.01-1.04).Conclusions: HIV status does not dampen the desire to have future children. There is need to evaluate the sexual, reproductive and mental health needs of PLHIV.
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Affiliation(s)
- Audrey M Pottinger
- Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Kamali Carroll
- The Hugh Wynter Fertility Management Unit, The University of the West Indies, Kingston, Jamaica
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