Child desire in women and men living with HIV attending HIV outpatient clinics: Evidence from a European multicentre study

Abstract

Objectives Fertility-related decisions are challenging for women and couples living with HIV, in spite of vertical HIV transmission rates lower than 1% under effective antiretroviral treatment. This multicentre study identified factors influencing child desire of women and men living with HIV in Europe.

Methods We gathered quantitative data by means of anonymous, self-administered questionnaires distributed through a network of 13 European HIV treatment centres. Data analysis employed descriptive statistics and multivariate logistic regression.

Results The majority of 427 heterosexual HIV-positive study participants were sexually active. Forty-three percent reported a child desire, 28% had unmet family planning needs. Factors independently associated with child desire were: being younger than 36 years for both genders, and having no children for women. Perceived HIV-related discrimination by health care providers was associated negatively with child desire for women, but positively for men.

Conclusions Many women and men living with HIV in Europe desire children and have fertility intentions, for which they need unbiased support to conceive and deliver safely. Comprehensive and gender-specific sexual and reproductive health counselling, including pre-conception and contraceptive counselling, should be integrated into HIV care delivery.

Keywords:

• Sexual and reproductive health
• HIV/AIDS
• Child desire
• Fertility
• Family planning
• Sexual and reproductive health services
• Human rights

ACKNOWLEDGEMENTS

Members of the Eurosupport V Study Group:

R. Colebunders (Institute of Tropical Medicine, University of Antwerp, Belgium); R. Borms (Sensoa, Belgium); B. Mumelter (Clinical Department of Medical Psychology and Psychotherapy, Innsbruck Medical University, Austria); G. Schmied (European Centre for Social Welfare Policy and Research, Vienna, Austria); J. Bogner, M. Müller (Clinic of Infectious Diseases, Ludwig Maximilian University, Munich, Germany); N. Dedes (Synthesis, Athens, Greece); C. Giaquinto, G. Bartoli, S. Faggion, C. Novello, S. Olleto (Department of Paediatrics, CARAP, Padua, Italy); C. Uberti, G. Galotta (Clinic of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy); L. Caldeira (University Hospital Santa Maria, Lisbon, Portugal); V. Gordillo (Universidad Complutense, Madrid, Spain); E. Wilkins, C. Murphy (North Manchester Health Care Trust, Manchester, UK); I. Prochazka (Institute of Sexology, University of Prague, the Czech Republic); D. Stanekova (National Reference Centre for HIV/AIDS Prevention, Slovak Medical University, Bratislava, Slovakia); P. Csépe (Department of Health, Semmelweis University, Budapest, Hungary); I. Kelle (Latvia's Association for Family Planning and Sexual Health, Riga, Latvia); Z. Izdebski, M. Pozdal (University Zielona Góra, Zielona Góra, Poland); D. Gredig, S. Nideröst (University of Applied Sciences Northwestern Switzerland, School of Social Work, Switzerland).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper. The latter reflects solely the authors’ view. The European Commission is not liable for any use that may be made of the information provided herein.

Funding: This study received funding from the European Commission, SANCO/Public Health [grant agreement no. 2004314]. Additional supporting grants were received from UCB Pharma, Bristol-Myers Squibb and Tibotec (Janssen-Cilag).