HIV-seropositivity is not important in childbearing decision-making among HIV-positive Ghanaian women receiving antiretroviral therapy

Abstract

Women in their reproductive years make up about 50% of all HIV-positive persons globally. These women, just as their HIV-negative counterparts, wield the right to procreate. However, HIV infection and lack of appropriate information on reproductive options may negatively impact women's procreative decision-making. This study assessed fertility intentions of HIV-positive women receiving antiretroviral therapy (ART) in southern Ghana. Quantitative methods were used to collect data from HIV-positive women receiving ART at four treatment centers. HIV-positive aged 18–49 years, and receiving ART were selected using systematic random sampling technique. Three hundred eighteen women were interviewed after informed consent. We used univariate analysis to generate descriptive tabulations for key variables. Bivariate analysis and logistic regression modeling respectively produced unadjusted and adjusted associations between background attributes of respondents and their childbearing decision-making. All analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Irrespective of age, reproductive history, and duration of HIV diagnosis, 46% of the women were desirous of procreating. The bivariate level analysis shows that women in their late reproductive ages (30–39 years) had the strongest desire to procreate (p < 0.001). After controlling for a number of covariates, primiparous and secundiparious women were about twice as likely to desire children (aOR = 2.553; 95% CI 1.480–4.401), and so were women aged 30–39 years (aOR = 2.149; 95% CI 1.202–3.843). Of 54% women who do not wish to procreate, achievement of desired family size (64.3%) was more popular a reason than fear of vertical transmission of HIV (7.5%), poor health status (5%), and pregnancy-related complications (1.6%).

Keywords:

• fertility intentions
• childbearing decision-making
• HIV-seropositivity
• ART
• Ghana

Acknowledgments

To all the HIV-positive women who voluntarily participated in the survey; to the management of the Fevers Unit of the Korle-Bu Teaching Hospital, the Tema General Hospital, the Atua Government Hospital, and the St Martin's de Porres Hospital, we are gratefull.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The field data collection component of this work was supported by the University of Ghana Research Fund administered and managed by the Office of Research, Innovation and Development under [grant number URF/6/ILG-019/2012-2013].