Fertility desire and associated factors among women of reproductive age living with HIV/AIDS attending antiretroviral therapy clinic in Arba Minch General Hospital, South Ethiopia, 2021

Background

The fertility desire of women living with HIV to have children can have significant implications for public health. Despite the increase in the number of HIV-positive women, the issues of their fertility desire have not been well-studied. This study aims to assess fertility desire and associated factors among women living with HIV/AIDS.

Methods

A facility-based cross-sectional study was conducted from 1 May to 30 July 2021. The researchers employed a systematic sampling technique. The data were gathered and entered into EpiData 3.1 software, and subsequently exported to the statistical package for social science version 25 for analysis. Binary logistic regression analyses were used to identify the factors involved, and a p-value of <0.05 at a 95% confidence level was deemed to be statistically significant.

Result

The findings of this study indicate that 47.8% of women expressed a desire to conceive. Various factors such as parents' pressure [adjusted odds ratio (AOR) = 4.41, 95% confidence interval (CI): 2.15-9.05], community pressure (AOR = 2.62, 95% CI: 1.30-5.26), being married (AOR = 0.25, 95% CI: 0.09-0.73), having only female offspring (AOR = 2.57, 95% CI: 1.12-5.90), and having HIV seropositive children (AOR = 2.45, 95% CI: 1.23-4.85) had statistically significant association with fertility desire.

Conclusion

The study area exhibited a high level of fertility desire. Various factors can influence fertility desire, including parents' pressure, community pressure, being married, having only female offspring, and having children who are HIV seropositive. When developing interventions on sexual and reproductive health issues, it is imperative for policymakers and healthcare providers who are working in antiretroviral therapy clinics to take into account the effects of these factors on women living with HIV. When designing and implementing prevention of mother-to-child transmission services, it is important to consider the fertility desires of mothers who are living with HIV.

Fertility Desire, Knowledge of Prevention of MCT of HIV and Associated Factors Among Men and Women Attending ART Clinic at Public Health Institutions of West Shoa Zone, Oromia, Ethiopia, 2020

Background

Globally, the human immunodeficiency virus (HIV) affects young people in their reproductive years. Most of the studies conducted in Ethiopia focus on the fertility desire of women of reproductive age and did not give due consideration to the men’s fertility perspective. Thus, this study aimed to assess the fertility desire, knowledge of prevention of mother to child of HIV (PMTCT), and associated factors among HIV-positive men and women attending ART clinic at west Shewa zone, Oromia region, Ethiopia, 2020.

Methods

Facility-based cross-sectional study design was applied to identify fertility desire, PMTCT knowledge, and associated factors among 590 HIV-positive reproductive age group men and women attending ART clinics at public health institutions of West Shewa zone. Data were collected by pre-tested structured questionnaires and analyzed using SPSS version 22. Binary logistic regression analysis was used to examine the association of predictors on fertility desire and knowledge about PMTCT. Odds ratio, 95% CI, and P value 0.05 were used to measure the statistical association.

Results

The prevalence of fertility desire and knowledge of PMTCT in the study area were 58.8% and 30.7%, respectively. The odds of fertility desire were higher among the respondents aged >25 years [AOR=4.64, 95% CI (2.75–7.85)], housewives [AOR=3.14, 95% CI (1.90–5.21)], merchants [AOR=5.31, 95% CI (2.55–11.05)], ART use for ≤5 years [AOR=5.13, 95% CI (2.37–11.12)] and among those voluntarily tested to know their HIV status [AOR=2.16, 95% CI (1.30–3.58)]. Besides, the odds of fertility desire were low among husband who cannot read and write [AOR=0.07, 95% CI (0.02–0.23)], primary education [AOR=0.22, 95% CI (0.09–0.56)], and secondary education [AOR= 0.32, 95% CI (0.14–0.73)] when compared with husband education of college and above. Likewise, the odds of PMTCT knowledge were higher among the respondents aged less than 25 years [AOR=2.53, 95% CI (1.32–4.86)] who undergone voluntary testing during HIV diagnosis reasons [AOR=1.55, 95% CI (1.03–2.35)], and ART use for more than five years [AOR=1.94, 95% CI (1.26–2.98)].

Conclusion

Younger age, husband education, occupation, recent HIV test, and voluntary testing were significantly associated with fertility desire. Likewise, the younger age group, voluntary testing and counseling, and those on ART for more than five years had higher odds of PMTCT knowledge. Therefore, strengthening voluntary testing and counseling strong counseling on PMTCT throughout the follow-up care and involvement partners is of paramount importance should be insured to decrease MTCT.

Contraceptive use among sexually active women living with HIV in western Ethiopia

Introduction

Contraception can help to meet family planning goals for women living with HIV (WLHIV) as well as to support the prevention of mother to child transmission of HIV (PMTCT). However, there is little research into the contraceptive practice among sexually active WLHIV in Ethiopia. Therefore, we aimed to examine contraceptive practice among sexually active WLHIV in western Ethiopia and identify the factors that influenced such practice using the Health Belief Model (HBM).

Methods

A facility-based cross-sectional survey of 360 sexually active WLHIV was conducted from 19^th March to 22^nd June 2018 in western Ethiopia. The eligible participants were WLHIV aged between 18 and 49 years who reported being fecund and sexually active within the previous six months but were not pregnant and not wanting to have another child within two years. Modified Poisson regression analyses were conducted to identify factors that influenced contraceptive practice among sexually active WLHIV in western Ethiopia.

Results

Among sexually active WLHIV (n = 360), 75% used contraception with 25% having unmet needs. Of the contraceptive users, 44.8% used injectables, 37.4% used condoms and 28.5% used implants. Among 152 recorded births in the last five years, 17.8% were reported as mistimed and 25.7% as unwanted. Compared to WLHIV having no child after HIV diagnosis, having two or more children after HIV diagnosis (Adjusted Prevalence Ratio [APR] = 1.31; 95%CI 1.09–1.58) was associated with increased risk of contraceptive practice. However, sexually active unmarried WLHIV (APR = 0.69; 95%CI 0.50–0.95) were less likely to use any contraception compared to their sexually active married counterparts. Importantly, high perceived susceptibility (APR = 1.49; 95%CI 1.20–1.86) and medium perceived susceptibility (APR = 1.55; 95%CI 1.28–1.87) towards unintended pregnancy were associated with higher risk of contraceptive use than WLHIV with low perceived susceptibility.

Conclusions

Although contraceptive use amongst sexually active WLHIV was found to be high, our findings highlight the need for strengthening family planning services given the high rate of unintended pregnancies, the high rate of unmet needs for contraception, as well as the lower efficacy with some of the methods. Our findings also suggest that the HBM would be a valuable framework for healthcare providers, programme planners and policymakers to develop guidelines and policies for contraceptive counselling and choices.