Desire for Children and Pregnancy Risk Behavior among HIV-Infected Men and Women in Uganda

Nakayiwa, Sylvia; Abang, Betty; Packel, Laura; Lifshay, Julie; Purcell, David W.; King, Rachel; Ezati, Enoch; Mermin, Jonathan; Coutinho, Alex; Bunnell, Rebecca

doi:10.1007/s10461-006-9126-2

Cited by 137 publications

(153 citation statements)

References 18 publications

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“…And nearly 10% of the sero-discordant partners still decided to have a child; the study result showed that, participants whose partner's test result was negative were 63% less likely for fertility decision than with positive result [AOR, 95% CI 0.366 (0.193, 0.907)], (P<0.001). This is in line with other studies conducted in Uganda (11). This could be due to fear of infecting their partner, which could raise an issue of SRH right of PLWHA.…”

Section: Discussionsupporting

confidence: 91%

“…Men were found almost twice more likely to decide on fertility than women [AOR, 95%CI, 1.78 (1.15, 2.74)] (p<0.01). This finding is higher than the study conducted in Uganda (16%) and consistence in its pattern in that men were almost four times more likely to want more children than women (11). The study also revealed that current fertility decision among men was lower than a study conducted in Brazil (50.1%).…”

Section: Discussioncontrasting

confidence: 72%

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Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

Getachew¹,

Alemseged²,

Abera³

et al. 2011

Ethiopian Journal of Health Development

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Background: In a setting with high HIV prevalence and high fertility rates, addressing fertility issues of People Living with HIV/AIDS (PLWHA) is crucial. However, understanding of the factors associated with fertility decisions of PLWHA in Ethiopia is remarkably low. Objective: The study was conducted to assess factors associated with fertility decisions of PLWHA in South Wollo Zone, Northeast Ethiopia. Methods: The study was conducted from February 1 to March 30, 2008 using cross-sectional design. Quantitative data were collected from a sample of 458 men and 458 women using structured questionnaire. Qualitative data were also collected from six health care providers. During in-depth interview the health care providers indicated the fertility related counseling service to be low. Conclusion:In spite of the fact that significant proportion of married PLWHA had decided to have a child, the fertility related counseling service is low. Improving fertility related counseling services to enable clients make informed fertility decision is mandatory. The factors identified to be associated with fertility decision could be of major importance and as such should be investigated further. [Ethiop. J. Health Dev.2010;24(3):214-220]

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 72%

Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

Getachew¹,

Alemseged²,

Abera³

et al. 2011

Ethiopian Journal of Health Development

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“…[15,16] Some studies have shown HIV-positive status to be associated with low fertility intentions and at the same time low contraceptive use. [17,18,3] In particular, a multi-country analysis of Demographic and Health Survey (DHS) data from nine countries revealed lower contraceptive uptake among HIV-positive women with prior knowledge of their status than counterparts who were HIV-negative in three of the countries included in the study: Zimbabwe, Kenya, and Malawi. [16] The apparent disconnect between fertility desire and contraceptive uptake among HIV-positive women has been attributed to diverse factors ranging from social desirability or stigma surrounding childbearing for HIV-positive individuals [19] to low contraceptive use among HIV-positive women based on the perception that they and their partners were infertile due to HIV infection [20].…”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS and contraceptive use: factors associated with contraceptive use among sexually active HIV-positive women in Kenya

Magadi

2017

Contraception

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T Results:The study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities. It further reveals striking differences in factors associated with contraceptive uptake between HIV-positive and HIV-negative women. Education and the desire to stop childbearing are strongly associated with contraceptive uptake among uninfected women, but both factors are not significant among HIV-positive women for whom wealth is the most important factor. While HIV-negative women in the richest wealth quintile are about twice as likely to use contraceptives as their counterparts of similar characteristics in the poorest quintile, this gap is about seven-fold among HIV-positive women. Conclusion:These findings suggest that having the desire and relevant knowledge to use contraceptives does not necessarily translate into expected contraceptive behavior for HIVpositive women in Kenya and that poor HIV-positive women may be particularly in need of increased access to contraceptive services. Implications: Study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities in Kenya. Results reveal striking differences in factors associated with contraceptive use between HIV-positive and HIV-negative women. Poverty may be an impediment to contraceptive uptake among HIV-positive women in Kenya.

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“…HIV transmission risk in patients on HAART is low only if the following conditions are met: the HIV-infected patient is receiving HAART with excellent adherence; patients disclose their HIV status and inquire about HIV status of their sexual partners; the viral load is consistently undetectable for a long time; and no sexually transmitted infections (STIs) are present in either partners. The above conditions are not met in many sub-Saharan African settings, as many studies [56][57][58][59][60][61] report that sub-optimal adherence, high fertility intentions, and risk factors for acquisition of STI (such as multiple sexual partners, and inconsistent condom use) are common. In many settings in sub-Saharan Africa, such as eastern and southern Africa, high-risk behaviors occur in HIV patients before and after initiating HAART [62][63][64][65].…”

Section: Discussionmentioning

confidence: 99%

The impact of highly active antiretroviral therapy on high-risk behaviour of HIV-infected patients in sub-Saharan Africa

Kaye

Kakaire

Osinde

et al. 2013

J Infect Dev Ctries

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Introduction: High-risk sexual behaviors such as multiple sexual partners, inconsistent condom use, acquisition of sexually transmitted infection (STIs), and non-use of contraceptives persist in HIV patients undergoing care. We conducted a systematic review of studies conducted in the era of increased access to HAART (2000HAART ( -2010 to assess whether wide-scale use of HAART was associated with high-risk behavior among HAART-using patients. Methodology: We conducted a comprehensive search of databases (AIDSLINE, National Library of Medicine, MEDLINE, PubMed, CINHAL and EMBASE) from January 2002 to January 2010, reviewed conference proceedings and journals, and contacted the researchers involved. We analyzed the association of high-risk behaviors (non-disclosure of sero-status to sexual partners, inconsistent condom use, unprotected sexual intercourse, multiple sexual partners, non-use of contraceptives and acquisition of STIs) with using HAART. Information from eligible studies was abstracted using a standardized checklist. Fourteen English-language studies met the selection criteria of having high-risk behavior as an outcome in patients using HAART in sub-Saharan Africa. Results: Of the 92 eligible articles screened, 14 met the criteria for inclusion as primary articles, 10 showed that HAART is not associated with increased high-risk behavior, two showed increase in acquisition of STIs among HAART-using patients, (which was inconsistent with other measures of high-risk behavior), and two studies showed short-term increase in high-risk behavior. Conclusions: Persistence of high-risk behavior in HAART-using patients suggests that more effort needs to be incorporated in HIV care to reduce such behavior to reduce HIV transmission to uninfected populations.

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Desire for Children and Pregnancy Risk Behavior among HIV-Infected Men and Women in Uganda

Cited by 137 publications

References 18 publications

Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

HIV/AIDS and contraceptive use: factors associated with contraceptive use among sexually active HIV-positive women in Kenya

The impact of highly active antiretroviral therapy on high-risk behaviour of HIV-infected patients in sub-Saharan Africa

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