My intention was a child but I was very afraid: fertility intentions and HIV risk perceptions among HIV-serodiscordant couples experiencing pregnancy in Kenya

Abstract

We sought to understand fertility intentions and HIV risk considerations among Kenyan HIV-serodiscordant couples who became pregnant during a prospective study. We conducted individual in-depth interviews (n = 36) and focus group discussions (n = 4) and performed qualitative data analysis and interpretation using an inductive approach. Although most of the couples were aware of the risk of horizontal and vertical HIV transmission, almost all couples reported that they had intended to become pregnant and that the desire for children superseded HIV risk considerations. Motivations for pregnancy were numerous and complex: satisfying desired family size, desire for biological children, maintaining stability of the union, and sociocultural pressures. Couples desired strategies to reduce HIV risk during conception, but expressed hesitation toward assisted reproductive technologies as unnatural. HIV prevention programs should therefore address conception desires and counsel about coordinated periconception risk-reduction strategies.

Keywords:

• fertility
• HIV
• serodiscordant couples
• Kenya

Acknowledgements

We are grateful to John Njoroge for facilitating the interviews, the couples who participated in this study, the teams at the Thika, Kenya, study site and at the University of Washington for their work on this study.

Funding

This study was funded by the US National Institutes of Health [grant number R21 NR012663] and the Bill and Melinda Gates Foundation [grant number OOP47674].

Additional information

Funding

Funding: This study was funded by the US National Institutes of Health [grant number R21 NR012663] and the Bill and Melinda Gates Foundation [grant number OOP47674].