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“I prefer not to have a child than have a HIV-positive child”: a Mixed Methods Study of Fertility Behaviour of Men Living with HIV in Northern Nigeria

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Abstract

Background

In the era of HIV treatment as prevention, little research has focused on the fertility behaviour of men living with HIV. This study examines the predictors and motivators of fertility among men living with HIV and on antiretroviral treatment in Kano, Nigeria.

Method

Using mixed methods, structured questionnaires were administered to a clinic-based sample of men living with HIV (n = 270) and HIV-negative/untested controls (n = 270), followed by in-depth interviews with a sub-group of 22 HIV-positive participants. Logistic regression and the framework approach were used to analyse the data.

Results

Compared to HIV-negative/untested controls, lower proportions of men living with HIV desired more children (79.3%, n = 214 vs. 91.1%, n = 246, p < 0.05) and intended to bear children within 3 years (57.0%, n = 154 vs. 67.0%, n = 181) (p < 0.05). Marital status (ever married vs. single) predicted fertility intention among men living with HIV (adjusted odds ratio, AOR = 4.70, 95% confidence interval CI, 1.75–13.64) and HIV-negative/untested controls (AOR = 4.23, 95% CI, 1.37–16.45). Men considered self and partner health status, HIV transmission risks, poverty, the effectiveness of interventions, child survival and religion when making fertility decisions.

Conclusion

Fertility desires remain high post-HIV diagnosis. HIV services should include integrated reproductive health programs that address the fertility desires of clients and include considerations for fertility services.

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Acknowledgements

We thank our research assistants, Mr. Aliyu Mande and Dr. Musa Bello.

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Authors and Affiliations

  1. Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK

    Zubairu Iliyasu, Jenny Owen & Padam Simkhada

  2. Department of Community Medicine, Bayero University Kano, Kano, Nigeria

    Zubairu Iliyasu

  3. Department of Health Policy & Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA

    Muktar H. Aliyu

  4. School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK

    Padam Simkhada

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  1. Zubairu Iliyasu
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Correspondence to Zubairu Iliyasu.

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Ethical clearance was obtained from the ethics committees of Aminu Kano Teaching Hospital, Nigeria and the School of Health and Related Research at the University of Sheffield, UK. All participants provided written informed consent.

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Iliyasu, Z., Owen, J., Aliyu, M.H. et al. “I prefer not to have a child than have a HIV-positive child”: a Mixed Methods Study of Fertility Behaviour of Men Living with HIV in Northern Nigeria. Int.J. Behav. Med. 27, 87–99 (2020). https://doi.org/10.1007/s12529-019-09837-9

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