Desire for a child among HIV-infected women receiving antiretroviral therapy in Cameroon: results from the national survey EVAL (ANRS 12-116)

Abstract

The majority of HIV-infected people in sub-Saharan Africa are women, many of reproductive age. Cameroon is severely hit by the AIDS epidemic and has developed a large national program for improving access to antiretroviral treatment (ART). The reproductive intentions of women living with HIV/AIDS (WLHA) who obtain access to ART in this country remain poorly documented. Our study aimed at exploring factors associated with the desire to have a child among 1433 ART-treated fertile WLHA aged <50. Analyses were based on data collected during the national cross-sectional survey EVAL (ANRS 12-116), which was conducted between September 2006 and March 2007 in 27 HIV care centers in Cameroon. Logistic regression was used to explore factors associated with women's desire to have a child, defined as reporting the wish to have a/another child.

A total of 791 women (55%) reported the desire to have a child. After adjusting for age, matrimonial status, number of biological children, and sexual activity, the main factors independently associated with this desire in a multivariate analysis were having a good physical health-related quality of life (1.02 [1.01–1.03] for a one-point increment on the 12-item Short-Form Health Survey scale) and a CD4 count at ART initiation <200 cells/mm³ (1.7 [1.2–2.4]). As a conclusion, the desire to have a child is frequent among ART-treated WLHA in Cameroon. HIV care and family planning programs should be integrated more thoroughly in order to support WLHA's reproductive choices.

Keywords:

• antiretroviral therapy
• desire for a child
• Africa

Acknowledgements

We would like to thank the French National Agency for Research on AIDS and viral hepatitis (ANRS) which funded this research and the Cameroonian Ministry of Health for its support in the implementation of the EVAL survey. We would also like to thank all the patients who accepted to participate in the survey as well as healthcare providers for their strong involvement in the data collection stage. The EVAL study group members were: S. Koulla-Shiro (Central Hospital, Yaoundé, Cameroon), P. Ongolo-Zogo (Ministry of Public Health - Division of Health Operations Research, Yaoundé, Cameroon), J. Blanche, A-D Bouhnik, S. Boyer, M-P Carrieri, A. Dia, F. Eboko, S. Loubière, F. Marcellin, J-P Moatti, Y. Obadia, C. Protopopescu, B. Spire (INSERM, IRD, University of the Mediterranean UMR 912, Marseilles, France), S-C Abega, C. Abé, P. C. Bilé, C. Bios, R-C Bonono, Y. Mehe, M. T. Mengue, H. Mimcheu, F. Mounsade, L. M. Ngaba, J. Ngo Mbog, S. Ngo Yebga, H. Nkwidjan (IRSA, catholic University of Central Africa, Yaoundé, Cameroon), and R. Nantchouang (GERCIS, catholic University of Central Africa, Yaoundé, Cameroon)

Notes

1. Resources for HIV/AIDS and Sexual and Reproductive Health Integration site, http://www.hivandsrh.org/

2. The EVAL survey is a research project which aims at evaluating the Cameroonian national program for improving access to ART. It was funded by the French National Agency for Research on AIDS and viral hepatitis (ANRS) and approved by the Ministry of Public Health in Cameroon and the Cameroonian National Ethics Committee.