Childbearing intentions of HIV-positive women of reproductive age in Soweto, South Africa: the influence of expanding access to HAART in an HIV hyperendemic setting
- PMID: 20403884
 - PMCID: PMC3020203
 - DOI: 10.2105/AJPH.2009.177469
 
Childbearing intentions of HIV-positive women of reproductive age in Soweto, South Africa: the influence of expanding access to HAART in an HIV hyperendemic setting
Abstract
Objectives: We investigated whether the intention to have children varied according to HIV status and use of highly active antiretroviral therapy (HAART) among women in Soweto, South Africa.
Methods: We used survey data from 674 women aged 18 to 44 years recruited from the Perinatal HIV Research Unit in Soweto (May through December 2007); 217 were HIV-positive HAART users (median duration of use = 31 months; interquartile range = 28, 33), 215 were HIV-positive and HAART-naive, and 242 were HIV negative. Logistic regression models examined associations between HIV status, HAART use, and intention to have children.
Results: Overall, 44% of women reported intent to have children, with significant variation by HIV status: 31% of HAART users, 29% of HAART-naive women, and 68% of HIV-negative women (P < .001). In adjusted models, HIV-positive women were nearly 60% less likely to report childbearing intentions compared with HIV-negative women (for HAART users, adjusted odds ratio [AOR] = 0.40; 95% confidence interval [CI] = 0.23, 0.69; for HAART-naive women, AOR = 0.35; 95% CI = 0.21, 0.60), with minimal differences according to use or duration of HAART.
Conclusions: Integrated HIV, HAART, and reproductive health services must be provided to support the rights of all women to safely achieve their fertility goals.
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References
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- UNAIDS Report on the Global HIV/AIDS Epidemic 2008. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2008
 
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- National HIV and Syphilis Prevalence Survey, South Africa 2006. Pretoria: Dept of Health, South Africa; 2007
 
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- South Africa Demographic and Health Survey 2003. Pretoria: Dept of Health, South Africa; 2004
 
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- Cooper D, Harries J, Myer L, Orner P, Bracken H, Zweigenthal V. “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med. 2007;65(2):274–283 - PubMed
 
 
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