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Meta-Analysis
. 2013 Apr 30:13:409.
doi: 10.1186/1471-2458-13-409.

Meta-analyses of fertility desires of people living with HIV

Yifru Berhan  1 , Asres Berhan
Affiliations
Meta-Analysis

Meta-analyses of fertility desires of people living with HIV

Yifru Berhan et al. BMC Public Health. .

Abstract

Background: Literature review has shown that some years back the fertility desires of people living with HIV was low but in the recent years, it was reported as increasing. However, little is known about the strength of association of fertility desire of HIV positive people with antiretroviral therapy (ART) experience, age, sex, education level, and number of children.

Methods: In these meta-analyses, twenty studies from different parts of the world were included. The odds ratios of fertility desires were determined using the random-effects model. Heterogeneity among the studies was assessed by computing values for Tau(2), Chi-square (Q), I(2) and P-value. Sensitivity analysis and funnel plot were done to assess the stability of pooled values to outliers and publication bias, respectively.

Results: The pooled analysis demonstrated that fertility desires of study participants had no association with ART. Similarly, the overall odds ratio did not show statistically significant association of fertility desires with sex and educational attainment of study participants although forest plots of some studies fall on increased and some others on decreased sides of fertility desires. The two variables that demonstrated a strong association with fertility desires were age less than 30 years and being childless. The lowest heterogeneity was found in a meta-analysis comparing ART experienced and ART naïve HIV positive people. In all meta-analyses, the sensitivity analyses showed the stability of the pooled odds ratios; and the funnel plots did not show publication or disclosure bias.

Conclusion: Although the fertility desires among childless and younger age group was very strong, we realized that quite a significant segment of HIV-infected people have desire for fertility. Therefore, including fertility issue as integral part of HIV patient care may help several of them in their reproductive decision making (letting them know the risks and methods of prevention while anticipating pregnancy).

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Figures

Figure 1
Figure 1
Flow diagram showing the process of study selection.
Figure 2
Figure 2
Meta-analysis of fertility desires of people living with HIV (Odds ratios of ART experienced vs ART naïve).
Figure 3
Figure 3
Meta-analysis of fertility desires of people living with HIV (Odds ratios of no child vs one or more child).
Figure 4
Figure 4
Meta-analysis of fertility desires of people living with HIV (Odds ratios of < 30 years vs 30 years and above).
Figure 5
Figure 5
Meta-analysis of fertility desires of people living with HIV (Odds ratios of male vs female).
Figure 6
Figure 6
Meta-analysis of fertility desires of people living with HIV (Odds ratios of primary or no education vs secondary and above).
See this image and copyright information in PMC

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