“If I don’t have children, they will know that I’m sick”: fertility desires of women and men living with HIV in Iringa, Tanzania

ABSTRACT

As safer conception services are expanded and integrated into HIV care systems, these services will need to address cultural, social, economic and medical concerns of women and men living with HIV. We conducted interviews with 30 HIV-positive women, 30 HIV-positive men, and 30 healthcare providers that examined factors specific to the experience of living with HIV that influence fertility desires in Iringa, Tanzania. HIV-related factors fell under five themes: knowing one could prevent mother-to-child transmission; reaching an ideal family size in the context of HIV-related infant mortality; concealing one’s HIV status; being able to provide for children; and managing HIV disease progression. Integration of safer conception counseling that includes locally-tailored messaging around desired family size, health risks, stigma and financial considerations into safer conception services will help people living with HIV reach their reproductive goals, while reducing the risks of HIV transmission.

KEYWORDS:

• HIV
• fertility desires
• safer conception
• Tanzania
• qualitative research

Acknowledgments

We thank our research participants and field interviewers (Joseph Mfangavo, Ritha Masamu, Eliezer Hokororo, and Isack Lwechungura). This work was supported by the U.S. Department of Education under a Fulbright-Hays Doctoral Dissertation Research Abroad Award.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Caitlin E. Kennedy http://orcid.org/0000-0001-6820-063X

Additional information

Funding

This work was supported by the U.S. Department of Education under a Fulbright-Hays Doctoral Dissertation Research Abroad Award.