Prevalence and factors associated with fertility desires among HIV-positive MSM

Figures & data

Table 1. Social characteristics of HIV-positive MSM in different fertility desire groups [n (%)].

Variables	Total	Fertility desire			p
		Yes	No	Did not make a decision
Total	129	46(35.6)	41(31.8)	42(32.6)
Year of diagnosis					0.692
Before 2014	26(20.2)	7(15.2)	11(26.8)	8(19.1)
2015–2017	31(24.0)	13(28.3)	9(21.9)	9(21.4)
2018–2020	72(55.8)	26(56.5)	21(51.2)	25(59.5)
Age (Years) Median (IQR)	26(23, 3)	26(24, 3)	28(23, 3)	25(23.3)	0.446
18–30	124(96.1)	45(97.8)	38(92.7)	41(97.6)
Others	5(3.9)	1(2.2)	3(7.3)	1(2.4)
Educational level					0.041
≤ High school	31(24.0)	9(19.5)	11(26.8)	11(26.2)
Bachelor	85(65.9)	27(58.7)	28(68.3)	30(71.4)
Master or above	13(10.1)	10(21.7)	2(4.9)	1(2.4)
Marriage					0.032
Single	106(82.2)	38(82.6)	29(70.7)	39(92.9)
Married	20(15.5)	7(15.2)	11(26.8)	2(4.8)
Divorced	3(2.3)	1(2.2)	1(2.4)	1(2.4)
Number of siblings					0.017
0	46(35.7)	24(52.2)	10(24.4)	12(28.6)
1	32(24.8)	12(26.1)	9(21.9)	11(26.2)
>1	51(39.5)	10(21.7)	22(53.7)	19(45.2)
Census register city					0.404
Beijing	19(14.7)	9(19.6)	6(14.6)	4(9.5)
Other Cities	110(85.3)	37(80.4)	35(85.4)	38(90.5)
Average income (RMB)					0.113
< 5000	44(34.1)	10(21.7)	20(48.8)	14(33.3)
< 10000	39(30.2)	15(32.6)	10(24.4)	14(33.3)
≥10000	46(35.7)	21(45.6)	11(26.8)	14(33.3)
Have stable income					0.308
Yes	106(82.2)	41(89.1)	32(78.1)	33(78.57)
No	23(17.8)	5(10.9)	9(21.9)	9(21.43)
Subsistence allowance					0.815
Yes	8(6.2)	2(4.4)	3(7.3)	3(7.1)
No	121(93.8)	44(95.6)	38(92.7)	39(92.9)

Table 2. Multinomial logistic regression of factors associated with fertility desires.

Fertility desire	Variables	Wald ${\chi }^2$	OR	95%CI		p
				lower	upper
No	Educational level
	≤ High school	1.844	3.58	0.57	22.53	0.174
	Undergraduate	3.276	4.69	0.88	25.02	0.070
	Graduate		ref
	Number of siblings
	0	6.571	0.24	0.08	0.71	0.010
	1	2.507	0.38	0.12	1.26	0.113
	>1		ref
	Marriage
	Single	1.131	0.53	0.16	1.71	0.288
	Married/Divorced		ref
Did not make a decision	Educational level
	≤ High school	3.326	8.47	0.85	84.25	0.068
	Bachelor	3.784	8.57	0.98	74.59	0.052
	Master or above		ref
	Number of siblings
	0	5.300	0.28	0.09	0.83	0.021
	1	1.617	0.46	0.14	1.52	0.203
	>1		ref
	Marriage
	Single	1.803	2.86	0.62	13.27	0.179
	Married/Divorced		ref

Ref: Yes.

Table 3. Desired way of reproduction.

Desired way of reproduction	Fertility desires
	Yes	Did not figure out	Total
Naturally conceived without protective measures	8(17.4)	7(16.7)	15(17.1)
IVF	5(10.9)	8(19.1)	13(14.8)
Sperm washing technique	7(15.2)	9(21.4)	16(18.2)
A surrogate	21(45.6)	11(26.2)	32(36.4)
Others (including monitoring ovulation and conception without protective measures; having sex after puncturing the condom; injecting semen into the vagina after external ejaculation, or others)	5(10.9)	7(16.7)	12(13.6)
Total	46	42	88

Table 4. Accuracy of reproductive knowledge among MSM [n (%)^a].

Reproductive Knowledge Scale^b		Fertility desire		Total
	Yes	No	Did not make a decision
n	46(35.6)	41(31.8)	42(32.6)	129
item1	15(32.6)	8(19.5)	14(33.3)	37(28.7)
item2	39(84.8)	31(75.6)	34(80.9)	104(80.6)
item3	37(80.4)	30(73.2)	33(78.6)	100(77.5)
item4	42(91.3)	37(90.2)	37(88.1)	116(89.9)
item5	30(65.2)	19(46.3)	20(47.6)	69(53.5)
item6	43(93.5)	38(92.7)	38(90.5)	119(92.3)
item7	41(89.1)	36(87.8)	36(85.7)	113(87.6)
item8	27(58.7)	22(53.7)	20(47.6)	69(53.5)
item9	21(45.6)	21(51.2)	20(47.6)	62(48.1)
item10	41(89.1)	34(82.9)	34(80.9)	109(84.5)
Total	336(73.0)	276(67.3)	276(68.1)	898(69.6)

a. N: correct number; %: proportion of correct number

b. Detail items of the Reproductive Knowledge Scale (the significant items were in bold):

Item1. During pregnancy preparation, the positive party needs to undergo antiviral therapy and the viral load test reaches sustained inhibition (< LDL (Lower Detection Limit) or less than 50 copies per milliliter), you can adopt condom-free sex. Item2. When preparing for pregnancy, the negative party needs to take prophylactic medication before and after exposure under the guidance. Item3. If the negative party has a negative antibody test before and after exposure to prophylaxis, the child does not need to be tested again after birth. Item4. Negative and positive parties need to be screened for venereal diseases and reproduction before pregnancy. Item5. Women need to take folic acid for three months to prepare for pregnancy. Item 6, without the intervention of antiviral treatment to prepare for pregnancy, it is possible to let each other be infected. Item7. Antiviral therapy can greatly reduce the risk of HIV transmission between spouses in singly positive families. Item8. If the women is HIV positive and the pregnancy is successful, the child born to her should take preventive drugs within 6 h after birth, which can reduce mother-to-child transmission. Item9. If the male is HIV positive, pregnancy preparation can be carried out after antiviral treatment is carried out. Item10. Untreated or unsuccessful serodiscordant families may cause infection of newborns and spouses.