Determinants of Fertility Desires among HIV Positive Women Living in the Western Highlands Province of Papua New Guinea

Abstract

The objective of this study was to identify determinants of fertility desires in HIV positive women living in the Western Highlands Province, Papua New Guinea, a male-dominated, patrimonial society. A cross-sectional study was conducted to collect data in February, 2010. Two hundred and ninety one HIV-infected women participated in personal interviews using a structured questionnaire. Sixty-six percent of the respondents were in polygamous relationships. Thirty-four percent of the participants desired a child in the future. Chi-square tests revealed that variables associated with desire for a child were age, marital status, number of children, current co-habitation with a partner, duration of time with a partner, receipt of the bride price, domestic physical violence, sexual activity in the previous three months, partner’s desire for a child, and current contraceptive use. Using multiple logistic regression, a partner’s positive desire for a child was the strongest predictor, with an odds ratio of 13.04 (95% CI = 5.6 -29.91). Fertility desires were largely influenced by dominant culturally sensitive issues and the family-oriented culture. The integration of effective counseling and reproductive healthcare service into HIV clinics is recommended. Holistic, culturally-relevant and family-oriented reproductive health counseling should provide more positive outcomes for both HIV-infected women and their children

<p>Fertility Desire and Its Determinants Among People Living with HIV in Antiretroviral Therapy Clinic of Teku Hospital, Nepal</p>

“…Categorization was carried out based on the obtained total score by adding up three of the above-mentioned variables. The classification was made as lower (0-10), middle (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and upper (26-29). About threequarters of the participants were in the lower socio-economic class in the Socioeconomic Status Scale of Kuppuswamy (Table 1).…”

“…14 Similarly, a study in Papua New Guinea revealed that having no children in the family (AOR: 3.6, 95% CI: 1.5-8.9) was associated with fertility desire in PLHIV. 15 Having a CD4 cell count >500 cells/mm 3 was associated with fertility desire in a study conducted among HIV-infected people starting ART in Uganda. This may be due to the improvement in their health status increasing the commitment of these people to achieve their reproductive desires.…”

Meta-analyses of fertility desires of people living with HIV

“…Rather, fertility desire was strongly associated with being young or childless, which both were likely to be interlinked one with the other and this kind of reflection is probably the reflection of the majority of human being in the fertile age regardless of HIV infection. In another study not included in this meta-analysis, being young or having few or no child was also an independent predictor for high fertility desire [16]. To the contrary, in another study, being young or single was reported to be inversely associated with fertility desire [39].…”

“…A partner’s desire for a child was one of the strongest predictors for women’s fertility desire [16]. In another study, being younger age, having fewer living children and higher quality of life were individually associated with fertility desire [17].…”

HIV-seropositivity is not important in childbearing decision-making among HIV-positive Ghanaian women receiving antiretroviral therapy

“…Persons infected with HIV are right-bearers. In line with this reasoning, two separate studies involving ARVexposed HIV-positive women in their reproductive ages found that a good number of them were sexually active, and desirous of having children (Aska, Chompikul, & Keiwkarnka, 2011;Loutfy et al, 2009). Some of the women (HIV-positive women living in Ontario, Canada), according to Loutfy et al had taken certain steps such as seeing a doctor and not using any contraceptive in order to conceive.…”