Fertility Desires of People Living With HIV in Enugu State Nigeria

Background Reproduction poses a problem for People Living with HIV/AIDS (PLWHIV), Public Health and clinical care providers. Studies suggest that discordance is a contributory factor to the high incidence of new HIV infections in Africa among partners in relationships. Unprotected sexual activity has a high risk for transmission and vertical transmission of HIV to the unborn child. Despite the odds, research has shown that fertility desires still exist among these groups with variations in perspectives on future fertility desires. Objectives The objectives of this study are to assess fertility desires among women and men living with HIV attending public health facilities as well as the determining factors, with the aim of providing information to support policy makers on the fertility desires of People Living With HIV. Methods This was a facility-based cross-sectional descriptive study which involved quantitative methods of data collection. Data was collected from 826 PLWHIV selected by systematic random sampling using a structured interviewer administered questionnaire. The data was analysed using SPSS version 18.0 and Epi-Info version 3.5.1 to compute percentages of PLWHIV with fertility desires in both facilities. The significance test was at p-values of 0.05. Results A total of 826 respondents were interviewed, mean age (standard deviation) 29.6 (8.0) years, 65.7 % were females while 58.6 % were married.55.4 % of them had at least 2 living children. The respondents who expressed a desire to have more children were 605 (73.2 %) out of whom 195 (32.2 %) expressed a desire to have one, two 231 (38.2 %) or greater than two 179 (29.6 %) children in the future. Only 23.7 % of the respondents would consider alternative to biological parenting and adoption was an option acceptable to all in this group. Factors determining fertility desires include age of females, sex, marital status, living with partner, occupation, education, having a child, number and sex of children, income, integration of services, alternative parenting and being on HAART treatment. Other factors associated with fertility desire include availability of VCT service, speaking to a health worker, losing a child to AIDS in the past, taking care of a child that is not one-s own, being in an intimate sexual relationship, partner having his/her own children and the year of diagnosis. Conclusion Reproductive health needs have been expressed by the PLWHIV so as to fulfill their reproductive goals and these needs are determined by several factors. Policies should be adapted within the specific context of the PLWHIV and their intimate main partners- reproductive needs.