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

• Type of Material: Article
• Authors: Jamie Krashin, Emory University; Lisa Haddad, Emory University; Hannock Tweya, Kamuzu Central Hospital; Jane Chiwoko, Kamuzu Central Hospital; Wingston Ng'ambi, Kamuzu Central Hospital; Bernadette Samala, Kamuzu Central Hospital; Thomas Chaweza, Kamuzu Central Hospital; Jennifer H. Tang, University of North Carolina; Mina C. Hosseinipour, Kamuzu Central Hospital; Sam Phiri, Kamuzu Central Hospital
• Language: English
• Date: 2018-06-13
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Krashin et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0198798
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 13
• Issue: 6
• Start Page: e0198798
• End Page: e0198798
• Grant/Funding Information: This study was conducted with funding from the Society of Family Planning (SPFR #11-14, PI: LBH), https://www.societyfp.org/Research-and-grants/Applying-for-grants.aspx.
• Keywords: Science & Technology; RISK BEHAVIOR; Multidisciplinary Sciences; SERVICES; CHILDBEARING; INFECTED WOMEN; ETHIOPIA IMPLICATIONS; SAFER CONCEPTION; Science & Technology - Other Topics; ANTIRETROVIRAL THERAPY; UGANDA; SOUTH-AFRICA; PREGNANCY INTENTIONS
• Research Categories: Health Sciences, Immunology; Health Sciences, Public Health

Abstract

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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.