Childbearing motivations, pregnancy desires, and perceived partner response to a pregnancy among urban female youth: does HIV-infection status make a difference?

Abstract

Despite a growing literature assessing pregnancy desires among HIV-infected women enrolled in clinical care, little attention has been paid to HIV-infected youth for whom pregnancy is a very relevant issue. In urban areas with high rates of teen pregnancy and HIV infection, further understanding of childbearing motivations and relationship dynamics influencing pregnancy desires among female youth is needed. This study compares the childbearing motivations, pregnancy desires, and perceived partner desire for a pregnancy among predominately African-American HIV-infected (n=46) and HIV-uninfected (n=355) female youth (15–24 years). An HIV-infected status was not significantly associated with childbearing motivations or the desire for a future pregnancy, p>0.10. HIV-infection was, however, associated with an increased likelihood to perceive that one's partner would have a positive response to a pregnancy (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.2–10.4, p=0.02) compared to uninfected peers. While race was not associated with participants’ own desire for a child, white youth were significantly less likely to perceive a positive partner response to becoming pregnant than their African-American peers (aOR 0.23, 95% CI 0.09–0.56, p=0.001). These data suggest that the desire for childbearing is not diminished by HIV infection among urban female youth, highlighting the need for routine, provider-initiated discussions about childbearing with urban youth to minimized unintended pregnancies and HIV transmission.

Keywords:

• childbearing motivations
• pregnancy desires
• pregnancy intentions
• perceived partner desire
• urban adolescents and youth
• HIV
• African-American
• HIV-infected female adolescents and youth
• preconception counseling
• childbearing desires and intentions

Acknowledgements

We are grateful to the HIV Women's Program for funding participant remuneration. We thank Drs. George Siberry and Nancy Hutton, Mary Joyner CPNP, Mary Ann Knott-Grasso CPNP, and Angela Williams for their assistance with recruitment, Shang-en Chung, MSc. for astute data management, and all the young women who shared their time and perspective by participating in the study. SFK had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.