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Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi.

ABSTRACT: As access to antiretroviral therapy increases, more HIV-infected patients in sub-Saharan Africa may desire fertility. We conducted a cross-sectional study of reproductive health knowledge, attitudes and practices to identify factors associated with desired fertility among women and men receiving care at two large public HIV clinics in Lilongwe, Malawi. Research assistants administered questionnaires to participants. We performed descriptive, bivariable and multivariable analysis of factors related to desired fertility and of factors related to contraceptive non-use among participants who did not desire fertility. One-third of participants desired future children. Having a partner who desired fertility and having lower parity were associated with desiring children among both genders. For women, believing that pregnancy was unhealthy was associated with decreased fertility desire. Fifty-five percent of women and 69% of men who did not want children in the future reported using contraception at last intercourse. Increasing age, lower parity, and making the decision to use contraception herself were associated with contraceptive non-use among women who did not desire fertility. Having discussed family planning with his partner was associated with contraceptive use among men who did not desire fertility. Knowledge of these factors can guide reproductive health counseling and service provision.

SUBMITTER: Krashin JW

PROVIDER: S-EPMC5999219 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi.

Krashin Jamie W JW Haddad Lisa B LB Tweya Hannock H Chiwoko Jane J Ng'ambi Wingston W Samala Bernadette B Chaweza Thomas T Tang Jennifer H JH Hosseinipour Mina C MC Phiri Sam S

PloS one 20180613 6

As access to antiretroviral therapy increases, more HIV-infected patients in sub-Saharan Africa may desire fertility. We conducted a cross-sectional study of reproductive health knowledge, attitudes and practices to identify factors associated with desired fertility among women and men receiving care at two large public HIV clinics in Lilongwe, Malawi. Research assistants administered questionnaires to participants. We performed descriptive, bivariable and multivariable analysis of factors relat ...[more]

PMID: 29897961

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Project description:ObjectiveDespite the increased emphasis on antiretroviral therapy and other healthcare services for HIV-infected individuals, issues of fertility desire have received relatively little attention. In particular, little is known about actual fertility desire and determinants of fertility desires among HIV-infected women and men receiving antiretroviral therapy.MethodsA cross-sectional study was conducted among HIV-positive individuals in public health hospitals of Addis Ababa City from 1 October to 30 November 2021. A pretested structured questionnaire was used to collect the data with a consecutive sampling technique. EpiData 4.6.2 and SPSS 25 were used for data entry and analysis. Bivariate and multivariable logistic regression analyses were done to identify factors associated with fertility desire. An adjusted odds ratio with a 95% confidence interval was computed for data interpretation. A p value of ⩽0.05 was considered to be statistically significant.ResultAmong 400 participants, 55% (95% confidence interval = 50%, 60%) have future fertility desire. Factors like age less than 35 years (adjusted odds ratio = 24.03, 95% confidence interval = 9.99, 57.83), a secondary education level (adjusted odds ratio = 2.78, 95% confidence interval = 1.21, 6.40), being married (adjusted odds ratio = 2.89, 95% confidence interval = 1.39, 5.99), being employed (adjusted odds ratio = 3.12, 95% confidence interval = 1.56, 6.24), being diagnosed with HIV in the past 1 year (adjusted odds ratio = 4.02, 95% confidence interval 2.07, 7.80) or past 2-4 years (adjusted odds ratio = 9.80, 95% confidence interval = 3.89, 26.02) have a significant association with future fertility desire. Respondents using contraceptives were 90.9% less likely to have future fertility desire (adjusted odds ratio = 0.09, 95% confidence interval = 0.05, 0.18).ConclusionThe magnitude of future fertility desire was founded high. Further research on this topic should include qualitative studies to provide a deeper understanding of people living with HIV fertility desires.

Project description:Background:Globally, unintended pregnancy has been very high accounting for 27% of maternal deaths. Different studies noted that nearly half of HIV positive women who gave unintended birth were using contraceptive methods prior to their unintended pregnancy. This implies that contraceptive failure contributes to unintended pregnancy. Long-term and permanent contraceptive methods are safe and effective contraceptive options. In women who are using long acting and permanent methods, the unintended pregnancy rate is very low and it is almost the same both in typical and perfect users. However, there is limited information on factors that affect long acting and permanent contraceptive methods utilization among Human Immuno-deficiency Virus (HIV) positive women in Ethiopia. Therefore, the purpose of this study was to assess long acting and permanent contraceptive utilization and its associated factors. Methods:An institution-based cross-sectional study was conducted among 505 married women attending care at Anti Retroviral Therapy (ART) clinics in Bahir Dar from March 16, 2014 to April 15, 2014. The data were collected using a structured and interviewer administered questionnaire. Both bivariate and multivariate logistic regressions were used to identify associated factors. Results:A total of 505 married women participated in the study with a response rate of 99.6%. The utilization of long acting and permanent contraceptive methods (LAPMs) was 27.5% [95% CI, 23.8-31.5]. The multivariate analyses showed that women who were getting pre- anti retroviral therapy (Pre-ART) services [Adjusted Odds Ratio?=?2.65, 95% confidence interval: 1.44, 4.86], had spousal discussion on family planning sometimes [Adjusted Odds Ratio?=?6.03, 95% CI:2.42-15.01] and frequently [Adjusted Odds Ratio?=?6.61, 95% confidence interval: 2.49-17.47], had previous experience on long acting contraceptive methods [Adjusted Odds Ratio?=?9.06, 95% confidence interval: 5.38-15.26], no exposure to myths about LAPMs [Adjusted Odds Ratio?=?2.07, 95% confidence interval: 1.24-3.45], had birth intention after 2 years [Adjusted Odds Ratio?=?6.95, 95% confidence interval: 3.35-14.42], and no such intention [Adjusted Odds Ratio?=?7.60, 95% confidence interval: 3.77-15.34] were factors significantly associated with utilization of long acting and permanent contraceptive methods. Conclusion:The utilization of long acting and permanent contraceptive methods was relatively high. Discussion with partners on family planning, previous experiences of LAPMs, not hearing myths about LAPMs, women not started ART, and no birth intention were positively associated with LAPMs utilization. It is therefore recommended that health service providers need to make couples counseling on FP, undergo behavioral change communication (BCC) to avoid misconceptions/myths regarding LAPMs. Further research is also recommended to address the gaps mentioned in the limitation section and to explore the reason/s for not using LAPMs (qualitative study).

Dataset Information

Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi.

Publications

Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi.

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