Fertility intentions of prenatal and postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: a longitudinal study

Figures & data

Figure 1 Hypothesized autoregressive model for fertility intention continuity.

Table 1 Fertility intention by socioeconomic, reproductive, HIV, partner and mental health characteristics prenatal at baseline

Characteristics	All	No fertility intention (n=457)	Fertility intention (n=224)	p-value
	Mean (SD), n (%)	Mean (SD), n (%)	Mean (SD) n, (%)
Socioeconomic status
Age	28.4 (5.7)	29.2 (5.8)	26.8 (5.2)	<0.001
Education
Grade 0–9	149 (21.5)	111 (75.0)	37 (25.0)	0.016
Grade 10–11	344 (49.6)	229 (67.6)	110 (32.4)
Grade 12 or more	200 (28.9)	117 (60.3)	77 (39.7)
Monthly household income (South African Rand)
<600 (ØS$50)	339 (48.9)	202 (59.9)	135 (40.1)	<0.001
≥600	354 (51.1)	255 (74.1)	89 (25.9)
Reproductive issues
Number of children
None	140 (20.2)	64 (46.0)	75 (54.0)	<0.001
One	270 (39.0)	167 (62.8)	99 (37.2)
Two or more	283 (40.8)	226 (81.9)	50 (18.1)
Pregnancy unplanned
No	320 (47.0)	223 (69.7)	97 (30.3)	0.177
Yes	361 (53.0)	234 (64.8)	127 (35.2)
Family planning knowledge#	4.5 (1.3)	4.6 (1.4)	4.3 (1.3)	0.010
Discussed with health care provider trying to get pregnant in the future
No	360 (52.9)	249 (69.2)	111 (30.8)	0.226
Yes	321 (47.1)	208 (64.8)	113 (35.2)
HIV issues
Diagnosed during this pregnancy
No	318 (45.9)	224 (71.3)	90 (28.7%)	0.031
Yes	375 (54.1)	233 (63.5)	134 (36.5%)
HIV knowledge#	13.8 (3.2)	14.0 (3.2)	13.4 (3.2)	0.010
Partner issues
Partner status
Married or cohabiting	285 (41.1)	194 (69.8)	84 (30.2)	0.217
Having partner (not married/cohabiting)	408 (58.9)	263 (65.3)	140 (34.7)
Disclosure of HIV serostatus (to partner)
No	279 (41.0)	183 (65.6)	96 (34.4)	0.483
Yes	402 (59.0)	274 (68.2)	128 (31.8)
HIV serostatus of spouse/partner
Negative/do not know	510 (74.9)	334 (65.5)	176 (34.5)	0.121
Positive	171 (25.1)	123 (71.9)	48 (28.1)
Study condition
Standard of care	357 (51.1)	250 (72.5)	95 (27.5)	0.003
Enhanced intervention	342 (48.9)	207 (61.6)	129 (38.4)

Notes:

# Mann–Whitney tests were used for median comparison of groups and chi-square tests for differences in proportions.

Table 2 Transition frequencies (probabilities) of fertility intention and moderating effects of intervention across four timepoints

Fertility intention		No	Yes	Row total	OR (95% CI)	Time-varying AORa (95% CI)	Time-invariant AORb (95% CI)
(a) Overall Sample (n =699)
		Time 2
Time 1	No	377 (80.7%)	90 (19.3%)	467 (100.0%)	9.89 (7.16–13.67)	10.31 (7.33–14.48)	11.40 (7.84–16.56)
	Yes	69 (29.7%)	163 (70.3%)	232 (100.0%)
		Time 3
Time 2	No	361 (80.9%)	85 (19.1%)	446 (100.0%)	3.65 (2.36–5.66)	2.67 (1.87–3.80)	4.08 (2.87–5.77)
	Yes	136 (53.8%)	117 (46.2%)	253 (100.0%)
		Time 4
Time 3	No	393 (79.1%)	104 (20.9%)	497 (100.0%)	3.85 (2.59–5.73)	3.55 (2.58–4.89)	4.32 (3.03–6.14)
	Yes	100 (49.5%)	102 (50.5%)	202 (100.0%)
(b) Standard of care (n =357)
		Time 2
Time 1	No	213 (82.6%)	45 (17.5%)	258 (100.0%)	10.38 (6.44–16.73)	11.30 (8.33–15.33)	13.17 (9.02–19.22)
	Yes	31 (31.3%)	68 (68.7%)	99 (100.0%)
		Time 3
Time 2	No	194 (79.5%)	50 (20.5%)	244 (100.0%)	2.29 (1.29–4.07)	2.07 (1.14–3.77)	2.26 (1.44–3.53)
	Yes	71 (62.8%)	42 (37.2%)	113 (100.0%)
		Time 4
Time 3	No	210 (79.2%)	55 (20.8%)	265 (100.0%)	3.66 (1.79–7.43)	3.42 (2.13–5.48)	4.74 (2.79–8.03)
	Yes	47 (51.1%)	45 (48.9%)	92 (100.0%)
(c) Enhanced intervention (n =342)
		Time 2
Time 1	No	164 (78.5%)	45 (21.5%)	209 (100.0%)	9.11 (6.24–13.30)	8.91 (5.33–14.88)	10.26 (6.26–16.81)
	Yes	38 (28.6%)	95 (71.4%)	133 (100.0%)
		Time 3
Time 2	No	167 (82.7%)	35 (17.3%)	202 (100.0%)	5.51 (3.10–9.77)	2.97 (2.25–3.94)	7.06 (4.43–11.26)
	Yes	65 (46.4%)	75 (53.6%)	140 (100.0%)
		Time 4
Time 3	No	183 (78.9%)	49 (21.1%)	232 (100.0%)	4.01 (2.69–5.98)	3.88 (2.26–6.67)	3.99 (2.56–6.20)
	Yes	53 (48.2%)	57 (51.8%)	110 (100.0%)

Notes: Total sample size (n=699) was used after utilizing multiple imputation for missing cases.

a AORs were estimated after adjusting the effects of baseline characteristics (time invarying covariates).

b AORs were estimated after adjusting the effects of all-time varying covariates. All ORs were significant at p<0.00.

Abbreviations: AOR, adjusted OR; OR, odds-ratio.

Table 3 Effects of baseline characteristics and time varying covariates on fertility intention across time (n=699)

Fertility intention	β	AOR (95% CI)
Model 1: Baseline characteristics
Education
Grade 0–9 (reference)	–	–
Grade 10–11	0.01	1.01 (0.83–1.23)
Grade 12 or more	0.09	1.10 (0.89–1.36)
Income (South African Rand)
600 or more (reference)	–	–
<600	−0.05	0.95 (0.74–1.22)
Partner status
Married or cohabitating (reference)	–	–
Having partner (not married/cohabitating)	−0.01	0.99 (0.84–1.17)
Children
None (reference)	–	–
At least one	−0.49***	0.61 (0.52–0.72)
Partner HIV status
Negative or unknown (reference)	–	–
Positive	−0.26**	0.76 (0.65–0.91)
Disclosure of HIV status to partner
No (reference)	–	–
Yes	0.22*	1.25 (1.03–1.51)
Model 2: variables assessed at four assessments
Knowledge
HIV knowledge	0.00	1.00 (0.97–1.03)
Family planning knowledge	−0.18***	0.84 (0.77–0.91)
Talked to health care provider about future pregnancy	0.29**	1.34 (1.12–1.61)
Partner issues
Disclosed HIV status to partner	−0.09	0.92 (0.76–1.11)
Consistent condom use	−0.09	0.92 (0.76–1.10)
Male involvement	0.07**	1.07 (1.03–1.11)
Psychological partner violence	−0.02	0.98 (0.97–1.00)
Physical partner violence	0.02	1.02 (0.99–1.04)

Notes: Logistic regression coefficients were held equal across all four timepoints. Also, all logistic regression coefficients were estimated after adjusting the intervention effects.

* p<0.05.

** p<0.01.

*** p<0.001.

Abbreviation: AOR, adjusted odds-ratio.