Mediation of the association between stigma and HIV status and fertility intention by fertility desire among heterosexual couples living with HIV in Kunming, China

Abstract

Objectives This study aimed to assess the influences of stigma and HIV status on reproductive intention among heterosexual couples living with HIV in China. Methods A cross-sectional study was conducted in Kunming, China among 315 HIV-positive individuals and their spouses (n = 315 couples). An interview questionnaire was used to collect data on intention, desire, HIV Stigma Scale items, and HIV status. Dyadic fertility intention was examined using the actor-partner interdependence mediation model, based on the Traits-Desires-Intentions-Behavior framework. Results The husbands’ or wives’ internalized stigma had significant negative effects on their own fertility desire (β = −0.149, p<0.05 and β = −0.238, p<0.01, respectively). HIV-positive status of the husbands was weakly linked to their own fertility intention (β = −0.181, p<0.05). Husbands’ perceived provider stigma was associated with their own and their wives’ fertility intention via the mediating effect of their fertility desire (β = −0.374, p<0.001 and β = −0.203, p<0.01, respectively). The cumulative influence of their reproductive desire mediated the husband’s perceived provider stigma and the wife’s internalized stigma on their fertility intention. Conclusions Stigma and HIV status were associated with fertility intention among couples living with HIV, mediated by fertility desire. The high intra-couple correlation suggested that counseling should be conducted when both spouses are present together with extensive discussions on concerns regarding HIV-related stigma, potential discrepancies between each partner’s fertility desire and intention, and the influence of one partner on the other.

Defining HIV-Related Social Support: What Types of Social Support Do People With HIV Need?

“…Under these circumstances, the impact of HIV on crucial life milestones can significantly influence the decision-making process for PWH. They may face uncertainties when making important life choices, such as whether to get married and have children (Gigstad et al, 2023; Guo et al, 2022); whether to disclose their HIV status to friends, family, sexual partners, and others (Yang et al, 2023); and whether to change jobs or avoid jobs with HIV testing involved in pre-employment or annual medical examination (Celeste-Villalvir et al, 2023). Effective appraisal support requires that support providers not influence PWH's decision-making with personal subjective tendencies and preferences.…”

Effects of (In)Congruency in Fertility Motivation on Fertility Desire and Intention Among Couples Living with HIV: A Dyadic Approach

“… 25 The previous studies used a dyadic approach to assess the fertility desire and intention by other factors such as stigma, HIV status, HIV-related worriers and living children. 26 , 27 …”

“…25 The previous studies used a dyadic approach to assess the fertility desire and intention by other factors such as stigma, HIV status, HIV-related worriers and living children. 26,27 The objective of the current study was to document the effects of (in)congruency in fertility motivation linked to intention via desire among CLWH using the APIM and DRSA. To achieve this objective, we divided the analysis into three parts: the causal pathway; degree of husband-wife congruence of fertility motivations; and congruency effect of fertility motivation between wives and husbands on fertility desire/intention.…”

Family of Origin Characteristics as Predictors of Childbearing Motivations

“…Despite the fact that there are various studies that relate the TDIB model to various variables such as politics (Liu et al, 2023), fatal diseases (Buber-Ennser et al, 2023;Djiometio et al, 2019;Guo et al, 2022), race (Alexander et al, 2021), couple relationship (Barber et al, 2019), among others; empirical evidence of family of origin characteristics as predictors of CM in the national and international literature is scarce (Rich et al, 2021;Varas & Borsa, 2021). Gerson (1980Gerson ( , 1983Gerson ( , 1984Gerson ( , 1986, assessed the impact on CM of perceived parental attention, parental identification, and happiness of family life in childhood and the results indicated that CMs are correlated with the aforementioned variables.…”