Socio-Demographic and Behavioral Factors Associated with the Desire to Procreate Among Patients Living with HIV in Gabon

Abstract

The desire to procreate in patients living with HIV (PLHIV) has been seldom investigated in Africa, particularly in Gabon. The aim of this transversal and descriptive study was to analyze the socio-demographic and behavioral factors associated with a desire to have children in a cohort of PLHIV. The study included 442 patients, predominantly females [79.9% (337/422)], and those with a secondary school education [64.2% 271/422)]. The highest prevalence of HIV was found in patients aged 30-39 years old (44.3%), of which 59% (249/422) were unemployed. The desire to have children was noted in 78% (329/422) of patients, of which 82.4% (271/329) were treated with antiretroviral drugs; this was significantly higher in subjects under 40 years versus those over 40 years old [81% (268/329) versus 19% (61/329), p<0.001]. Sero-discordant couples represented 33.4% (110/329) of patients. The frequency of patients with the desire to have a child was significantly higher when patients wanted to hold the status of parent of a child [77% (255/329) versus 23% (74/329), p<0.001]; this was influenced by the partner's desire [60% 197/329 versus 40% (132/329), p< 0.001], as well as by the absence of weight loss [56% (185/329) versus 44% (144/329), p<0.001]. The average number of children was significantly lower in patients with the desire to procreate compared to those with no desire to have children [1.7 versus 3.2, p<0.001]. These first observations in Gabon highlight the importance of the desire to have children in PLHIV and sero-discordant couples, and they show the level of interest in developing assistance methods for procreation and family planning programs to help this population, as well as to reduce the risk of mother-to-child HIV transmission.

Prevalence and factors associated with fertility desires/intentions among individuals in HIV‐serodiscordant relationships: a systematic review of empirical studies

“…In two studies, men were the most frequent partner living with HIV . In four studies, the sex of the index partner was not reported .…”

“…Concerning PLWH with a partner living without HIV, in three studies, most participants in serodiscordant relationships reported high fertility desires/intentions (62% to 81%) [53,61,62]. Also, among PLWH with a partner living without HIV, five studies presented percentages between 19% and 39% [24,52,[55][56][57].…”

“…In two studies, men were the most frequent partner living with HIV [47,60]. In four studies, the sex of the index partner was not reported [52,56,61,62]. Ten studies (10/21; 47.6%) did not report information about the research question that specifically assessed fertility desires/intentions.…”

Reproductive desire among women living with HIV/AIDS in Central Brazil: Prevalence and associated factors

“…Studies conducted in other countries have also found varying prevalence of reproductive desire among WLWHA. On the African continent, studies have shown varying prevalence, from 24.4% in Ethiopia to 78% in Gabon [ 30 , 31 , 32 , 18 , 33 ]. In Asia, one study found a prevalence of 34.0% in Iran [ 34 ].…”

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

“…12,18,19 A variety of factors influence fertility intentions. Younger age 6,[20][21][22][23] and smaller families [23][24][25][26][27] have been widely associated with intentions to have children among people living with HIV in sub-Saharan Africa. Some studies have demonstrated positive associations between desires for children and HIV serostatus disclosure.…”