Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services
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Tailoring sexual and reproductive health services to meet the needs of people living with the human immuno-deficiency virus (HIV) is a growing concern but there are few insights into these issues where HIV is most prevalent. This cross-sectional study investigated the fertility intentions and associated health care needs of 459 women and men, not sampled as intimate partners of each other, living with HIV in Cape Town, South Africa. An almost equal proportion of women (55%) and men (43%) living with HIV, reported not intending to have children as were open to the possibility of having children (45 and 57%, respectively). Overall, greater intentions to have children were associated with being male, having fewer children, living in an informal settlement and use of antiretroviral therapy. There were important gender differences in the determinants of future childbearing intentions, with being on HAART strongly associated with women’s fertility intentions. Gender differences were also apparent in participants’ key reasons for wanting children. A minority of participants had discussed their reproductive intentions and related issues with HIV health care providers. There is an urgent need for intervention models to integrate HIV care with sexual and reproduction health counseling and services that account for the diverse reproductive needs of these populations.
- Berer, M. (1999). HIV/AIDS, pregnancy and maternal mortality and morbidity: Implications for care. In M. Berer & T. K. Sundari Ravindran (Eds.), Safe motherhood initiatives: Critical issue (pp. 198–210). London: Blackwell Science Limited for Reproductive Health Matters.
- Bray, R. (2003). ‘Predicting the social consequences of orphanhood in South Africa’. CSSR Working Paper No. 29. Centre for Social Science Research. Cape Town: University of Cape Town.
- Chen, JL, Philips, KA, Kanouse, DE, Collins, RL, Miu, A (2001) Fertility desires and intentions of HIV-positive men and women. Family Planning Perspectives 33: pp. 144-152 CrossRef
- Cooper, D, Harries, J, Myer, L, Orner, P, Bracken, H, Zweigenthal, V (2007) ‘Life is still going on’: Reproductive intentions among HIV-positive women and men in South Africa. Social Science and Medicine 65: pp. 274-283 CrossRef
- da Silveira Rossi, A, Fonsechi-Carvasan, GA, Makuch, MY, Amaral, E, Bahamondes, L (2005) Factors associated with reproductive options in HIV-infected women. Contraception 71: pp. 45-50 CrossRef
- de Bruyn, M. (2005). Reproductive rights for women affected by HIV/AIDS. A project to monitor Millenium Development Goals 5 and 6. Chapel Hill, NC: Ipas.
- Department of Health. (2006). Republic of South Africa, summary report. National HIV and syphilis antenatal seroprevalence survey in South Africa. Pretoria: Government of the Republic of South Africa. Retrieved 1 October 2006 from: http:/www.health.gov.za.
- Doyal, L, Anderson, A (2005) My fear is to fall in love again. How HIV-positive African women survive in London. Social Science and Medicine 60: pp. 1729-1738 CrossRef
- Dyer, SJ, Abrahams, N, Hoffman, M, Spuy, ZM (2002) ‘Men leave me as I cannot have children’: Women’s experiences with involuntary childlessness. Human Reproduction 17: pp. 1663-1668 CrossRef
- Dyer, SJ, Abrahams, N, Mokoena, NE, Spuy, ZM (2004) You are a man because you have children’: Experiences, reproductive health knowledge and treatment seeking behaviour among men suffering from couple infertility in South Africa. Human Reproduction 19: pp. 960 CrossRef
- Gruskin, S, Ferguson, L, O’Malley, J (2007) Ensuring sexual and reproductive health for people living with HIV: An overview of key human rights, policy and health systems issues. Reproductive Health Matters 15: pp. 4-26 CrossRef
- Harries, J, Cooper, D, Myer, L, Bracken, H, Zweigenthal, V, Orner, P (2007) Policy maker and health care provider perspectives on reproductive decision-making amongst HIV-infected individuals in South Africa. Biomed Central Public Health 7: pp. 282
- Kaida, A, Andia, I, Maier, M, Bangsberg, DR, Spiegel, J, Bastos, FI, Gray, G, Hogg, R (2006) The potential impact of antiretroviral therapy on fertility in sub-Saharan Africa. Current HIV/AIDS Report 3: pp. 187-194 CrossRef
- Kirshenbaum, SB, Hirky, AE, Correale, J, Goldstein, RB, Johnson, MO, Rotheram-Borus, MJ, Ehrhardt, AA (2004) ‘Throwing the dice’: Pregnancy decision-making among HIV-positive women in four US cities. Perspectives on Sexual and Reproductive Health 36: pp. 106-112 CrossRef
- Magalhaes, J, Amaral, E, Giraldo, PC, Simoes, JA (2002) HIV infection in women: impact on contraception. Contraception 66: pp. 87-91 CrossRef
- McIntyre, J (2005) Preventing mother-to-child transmission of HIV: successes and challenges. BJOG: An International Journal of Obstetrics and Gynaecology 112: pp. 1196-1206 CrossRef
- Myer, L, Morroni, C, Rebe, K (2007) Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa. AIDS Patient Care and STDS 21: pp. 278-285 CrossRef
- Nebie, Y, Meda, N, Leroy, V, Mandelbrot, L, Yaro, S, Sombie, I, Cartoux, M, Tiendrebeogo, S, Dao, B, Ouangre, A, Nacro, B, Fao, P, Ky-Zerbo, O, Perre, P, Dabis, F (2001) Sexual and reproductive life of women informed of their HIV seropositivity: A prospective cohort study in Bukino Faso. Journal of Acquired Immune Deficiency Syndrome 28: pp. 367-372
- Orner, P., Cooper, D., Myer, L., Zweigenthal, V., Bekker, L.G., & Moodley, J. (2008). Clients’ perspectives on HIV/AIDS care and treatment and reproductive health services in South Africa. AIDS Care, doi: 10.1080/09540120701867008.
- Paiva, V, Filipe, EV, Santos, N, Lima, TN, Segurado, A (2003) The right to love: The desire for parenthood among men living with HIV. Reproductive Health Matters 11: pp. 91-100 CrossRef
- Paiva, V, Latorre, MR, Gravator, N, Lacerda, R (2002) Sexuality of women living with HIV in Sao Paulo. Cadernos de Saude Publica 18: pp. 109-118
- Sherr, L, Barry, N (2004) Fatherhood and HIV-positive heterosexual men. HIV Medicine 5: pp. 258-263 CrossRef
- Smits, AK, Goergen, CA, Delaney, JA, Williamson, C, Mundy, LM, Fraser, VJ (1999) Contraceptive use and pregnancy decision making among women with HIV. AIDS Patient Care and STDS 13: pp. 739-746 CrossRef
- Thornton, AC, Romanelli, F, Collins, JD (2004) Reproduction decision making for couples affected by HIV: A review of the literature. Topics in HIV Medicine 12: pp. 61-66
- UNAIDS. (2008). 2008 Report on the Global AIDS Epidemic. Geneva: Joint UN Program on HIV/AIDS (UNAIDS). Available at: http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp.
- Reproductive choices and family planning for people living with HIV. World Health Organization, Geneva
- Williams, CD, Finnerty, JJ, Newberry, RN, West, RW, Thomas, TS, Pinkerton, JV (2003) Reproduction in couples who are affected by human immunodeficiency virus: Medical, ethical and legal considerations. American Journal of Obstetrics and Gynecology 189: pp. 333-341 CrossRef
- Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services
AIDS and Behavior
Volume 13, Issue 1 Supplement, pp 38-46
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Reproductive intentions
- Influencing factors
- South Africa
- Industry Sectors
- Author Affiliations
- 1. Women’s Health Research Unit School of Public Health & Family Medicine, University of Cape Town, Anzio Road Observatory, 7925, Cape Town, South Africa
- 2. Western Cape Department of Health, Cape Town, South Africa
- 3. Desmond Tutu HIV Centre, Department of Medicine and Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Cape Town, South Africa
- 4. Department of Reproductive Health and Research, World Health Organisation, Geneva, Switzerland
- 5. Infectious Diseases Epidemiology Unit, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- 6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA