Reproductive Desire in Women Living with HIV/AIDS with Serodiscordant Partners.

OBJECTIVE: To estimate the prevalence and factors associated with reproductive desire in a sample of women living with HIV/AIDS (WLHA) with serodiscordant partners. STUDY DESIGN: Between September 2015 and August 2016, a cross-sectional study was conducted among 110 WLHA from HIV/AIDS treatment services and non-governmental organizations. An interview was conducted using a structured questionnaire to collect sociodemographic data, reproductive desire, and potential predictor variables. Poisson regression was used to analyze the factors associated with reproductive desire in the sample. RESULTS: The prevalence of reproductive desire was 32.7% (95% Confidence Interval: % CI: 24.7-42.0%). In regression analysis, we observed an association between reproductive desire and the following variables: age < 30 years; relationship time < 2 years; reproductive desire for the partner; and absence of children. CONCLUSIONS: The prevalence of reproductive desire in the investigated sample was relatively high. Young age and reproductive desire for the partner were the main associated factors.

Family planning knowledge, experiences and reproductive desires among women who had experienced a poor obstetric outcome in Lilongwe Malawi: a qualitative study.

BACKGROUND: Perinatal mortality is unacceptably high in low-income countries, including Malawi. Use of family planning to encourage birth spacing may optimize outcomes for subsequent pregnancies. However, the reproductive desires and family planning knowledge of women who have experienced a stillbirth or neonatal death in resource-poor settings are not well understood. METHODS: We examined family planning knowledge, contraceptive practices and barrier to contraceptive use among women who had experienced a poor obstetric outcome at Bwaila Hospital in Lilongwe, Malawi. We performed individual in-depth interviews or through focus group discussion with women who had experienced a stillbirth or early neonatal death, 4-8 weeks after their delivery. NVivo software was used to analyze data for recurrent patterns and themes, and central ideas were extracted to identify the data's core meanings. RESULTS: We interviewed 46 women who had experienced a poor obstetric outcome. Overall, women were aware of both modern and traditional family planning methods, and the majority were in favour of modern versus traditional methods. They also had knowledge about risks for future complications if they have a short inter-pregnancy interval. However, they faced conflict about whether to use family planning methods for their health, as suggested by their relatives and friends, or to have another child to fulfil their husband's desire, especially among those with no living child. Some had fear about side effects, while others were concerned that use of family planning methods without involving the husband could bring misunderstandings within the family. A number of women had misconceptions about family planning methods, which also served as a barrier to their use. CONCLUSION: Although women with a poor obstetric outcome are aware of modern family planning and its health benefits after their delivery, their decision to use a method is complicated by their own desire to protect their own health and the husband's desire for a child, particularly among those women with no living children coupled with fear of side effects and misconceptions. These findings suggest the importance of counselling both the affected woman and her husband about the benefits of family planning use, even after a poor obstetric outcome, to jointly choose the method they feel comfortable to use and dispel any misconceptions. TRIAL REGISTRATION: Clinicaltrials.gov NCT02674542.

Reproductive patterns and fertility wishes among HIV-infected patients: survey from six outpatient clinics in Denmark.

OBJECTIVES: Reproductive patterns among HIV patients in Denmark have not previously been described. We aimed to uncover the fertility wishes among Danish HIV-infected persons. METHODS: A cross-sectional questionnaire survey was done at six outpatient HIV clinics in Denmark. A total of 409 (56%) HIV patients returned the questionnaire; 323 had completed the questionnaire, although they had not all responded to all of the questions. RESULTS: Among HIV-infected individuals, 49% (137/280) had their own biological children. Fifteen percent (43/280) desired (additional) children and 15% (43/280) were undecided. Female gender, birth outside Europe, young age, completed high school education, heterosexuality, present partner, and non-disclosure were associated with a desire for children in the univariate analysis. In the multivariate analysis only young age, heterosexual orientation, and non-disclosure were significant. Thirty-seven percent (93/250) felt that HIV infection was a hindrance to having more children. The most common reasons indicated were fear of HIV transmission to the child (24%, 59/244) and to the partner (16%, 40/244). CONCLUSIONS: Many HIV-infected patients have children and a substantial proportion of HIV-infected patients desire (additional) children, although there is a high degree of fear of HIV transmission to their partner or child. This highlights the need for care providers to improve the services provided to HIV-infected patients who desire to have children.