Desire to Have Children: Gender and Reproductive Rights of Men and Women Living with HIV: A Challenge to Health Care in Brazil

Abstract

Links between HIV/AIDS care and reproductive health, including fertility options for people living with HIV (PLWH), have not been sufficiently addressed by health care providers. Moreover, few studies have addressed men in this regard. To describe attitudes toward parenthood and identify factors associated with desire to have children among men and women living with HIV a cross-sectional study involving a sample of 533 women and 206 men (bisexual and heterosexual) attending two reference sexually transmitted disease (STD)/AIDS centers in São Paulo, Brazil. Participants answered a standardized questionnaire. Desire to have children as the study outcome was compared between men and women and associated factors searched for in multivariable regression analysis. In contrast to previous studies conducted in developed countries, desire to have children in this sample was more frequent among men than among women and it was reported by 27.9% of participants (50.1% of men versus 19.2% of women). Women were more likely to anticipate doctors' strong opposition to PLWH getting pregnant and men reported lower information level about HIV/mother-to-child transmission (MTCT). Bisexual men were more likely to desire to have biologic children. Male gender, younger age, having no children, living with 1-2 children, and being in a heterosexual partnership were independently associated with desire to have children. Regardless of gender, the childless as well as the youngest should be regarded as groups to be particularly targeted by counseling, to be provided with objective information about reproductive rights and options. Further research is warranted to address the desire for children among strictly homosexual men.

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

“…Clients who were knowledgeable on PMTCT were about two times more likely for fertility decision than the non-knowledgeable ones [AOR, 95% CI 2.26 (1.44, 3.54)], (P<0.01). The result goes in line with other studies (10,12,15). A study in South African, indicated that the availability of PMTCT would influence PLWHA in favour of having children, sometimes wishing to replace a departed child or ensure that the child will not be infected (4).…”

“…The study also revealed that current fertility decision among men was lower than a study conducted in Brazil (50.1%). Likewise, women's fertility decision was lower than studies in Zimbabwe (54%), comparable with the study in Brazil (19.2%) but lower than the study in Uganda (7%) (12)(13)(14). This difference could be attributable to the difference in the operational definitions used.…”

A Social Ecological Approach to Exploring Barriers to Accessing Sexual and Reproductive Health Services among Couples Living with HIV in Southern Malawi

“…Similarly, the number of people living with HIV (PLWH) is increasing due to decreased mortality because of ART [1]. Similar situations have been noted in earlier studies in developed countries such as France, Brazil, and the United States of America [5,7,8].…”

“…With the advent of antiretroviral therapy (ART/ARV), worldwide health improvements have occurred over the last decades and the result has been a dramatic reduction in HIV-related morbidity and mortality, and improvements in quality of life [2][3][4][5]. HIV infection may now be considered a chronic illness because the ARVs suppress HIV replication thereby increasing CD4 cell count, delaying clinical progression of AIDS and prolonging survival [6].…”

Semen decontamination for the elimination of seminal HIV-1

“…Improvements made in multidrug highly active antiretroviral therapy (HAART) has resulted in infection with HIV becoming a manageable, chronic disease (Lambert-Niclot et al, 2012). However, the majority of infected individuals are in their reproductive years with the desire to have their own genetically related offspring (Sauer, 2005;Paiva et al, 2007;Kanniappan et al, 2008), and it would be unethical to deny access to ART (Englert et al, 2001;Gilling-Smith, Smith and Semprini, 2001). A recent South African HIV prevalence survey in 2012, by Shisana et al (2014) indicated that 12.2% of the national population (6.4 million persons) were HIV+.…”