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AIDS and Behavior

, Volume 13, Issue 5, pp 949–968 | Cite as

A Systematic Review of Factors Influencing Fertility Desires and Intentions Among People Living with HIV/AIDS: Implications for Policy and Service Delivery

  • Barbara Nattabi
  • Jianghong Li
  • Sandra C. Thompson
  • Christopher Garimoi Orach
  • Jaya Earnest
Original Paper

Abstract

With availability of antiretroviral treatments, HIV is increasingly recognised as a chronic disease people live with for many years. This paper critically reviews the current literature on fertility desires and reproductive intentions among people living with HIV/AIDS (PLHIV) and critiques the theoretical frameworks and methodologies used. A systematic review was conducted using electronic databases: ISI Web of Knowledge, Science Direct, Proquest, Jstor and CINAHL for articles published between 1990 and 2008. The search terms used were fertility desire, pregnancy, HIV, reproductive decision making, reproductive intentions, motherhood, fatherhood and parenthood. Twenty-nine studies were reviewed. Fertility desires were influenced by a myriad of demographic, health, stigma-associated and psychosocial factors. Cultural factors were also important, particularly in Sub-Saharan Africa and Asia. Future research that examines fertility desires among PLHIV should include cultural beliefs and practices in the theoretical framework in order to provide a holistic understanding and to enable development of services that meet the reproductive needs of PLHIV.

Keywords

HIV Pregnancy Fertility desire Child-bearing Reproductive behaviour Family planning 

References

  1. Airhihenbuwa, C. (1995). Health and culture: Beyond the western paradigm. Thousand Oaks: Sage Publications, Inc.Google Scholar
  2. Airhihenbuwa, C., & Obregon, R. (2000). A critical assessment of theories/models used in health communication for HIV/AIDS. Journal of Health Communication, 5(Supplement), 5–15. doi: 10.1080/10810730050019528.PubMedGoogle Scholar
  3. Aka-Dago-Akribi, H., Du Loû, A. D., Msellati, P., Dossou, R., & Welffens-Ekra, C. (1999). Issues surrounding reproductive choice for women lying with HIV in Abidjan, Côte d’ivoire. Reproductive Health Matters, 7(13), 20–29. doi: 10.1016/S0968-8080(99)90108-8.CrossRefGoogle Scholar
  4. Baek, C., & Rutenberg, N. (2005). Addressing the family planning needs of HIV-positive PMTCT clients: Baseline findings from an operations research study. Washington DC: Horizons Research Update.Google Scholar
  5. Bedimo, A. L., Bessinger, R., & Kissinger, P. (1998). Reproductive choices among HIV-positive women. Social Science and Medicine, 46(2), 171–179. doi: 10.1016/S0277-9536(97)00157-3.PubMedCrossRefGoogle Scholar
  6. Bedimo-Rung, A. L., Clark, R. A., Dumestre, J., Rice, J., & Kissinger, P. (2005). Reproductive decision-making among HIV-infected women. Journal of the National Medical Association, 97(10), 1403–1410.PubMedGoogle Scholar
  7. Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Research in Nursing and Health, 24(6), 518–529. doi: 10.1002/nur.10011.PubMedCrossRefGoogle Scholar
  8. Caldwell, J. C., & Caldwell, P. (1987). The cultural context of high fertility in sub-Saharan Africa. Population and Development Review, 13(3), 409–437. doi: 10.2307/1973133.CrossRefGoogle Scholar
  9. Chama, C., Morrupa, J., & Gashau, W. (2007). Sex and reproduction among HIV-infected people in Maiduguri, Nigeria. Journal of Obstetrics and Gynaecology, 27, 812–815. doi: 10.1080/01443610701711706.PubMedCrossRefGoogle Scholar
  10. Chen, J. L., Phillips, K. A., Kanouse, D. E., Collins, R. L., & Miu, A. (2001). Fertility desires and intentions of HIV-positive men and women. Family Planning Perspectives, 33(4), 144–152. doi: 10.2307/2673717.PubMedCrossRefGoogle Scholar
  11. Cooper, D., Harries, J., Myer, L., Orner, P., & Bracken, H. (2007). “Life is still going on”: Reproductive intentions among HIV-positive women and men in South Africa. Social Science and Medicine, 65(2), 274–283. doi: 10.1016/j.socscimed.2007.03.019.PubMedCrossRefGoogle Scholar
  12. Craft, S. M., Delaney, R. O., Bautista, D. T., & Serovich, J. M. (2007). Pregnancy decisions among women with HIV. AIDS and Behavior, 11(6), 927–935. doi: 10.1007/s10461-007-9219-6.PubMedCrossRefGoogle Scholar
  13. Daly, J., Willis, K., Small, R., Green, J., Welch, N., Kealy, M., et al. (2007). A hierarchy of evidence for assessing qualitative health research. Journal of Clinical Epidemiology, 60(1), 43–49. doi: 10.1016/j.jclinepi.2006.03.014.PubMedCrossRefGoogle Scholar
  14. Dyer, S. J., Abrahams, N., Hoffman, M., & van der Spuy, Z. M. (2002). ‘Men leave me as I cannot have children’: Women’s experiences with involuntary childlessness. Human Reproduction (Oxford, England), 17(6), 1663–1668. doi: 10.1093/humrep/17.6.1663.CrossRefGoogle Scholar
  15. Dyer, S. J., Abrahams, N., Mokoena, N. E., & van der Spuy, Z. M. (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 (Oxford, England), 19(4), 960–967. doi: 10.1093/humrep/deh195.CrossRefGoogle Scholar
  16. Ezeh, A. C. (1993). The influence of spouses over each other’s contraceptive attitudes in Ghana. Studies in Family Planning, 24(3), 163–174. doi: 10.2307/2939231.PubMedCrossRefGoogle Scholar
  17. Feldman, R., & Maposhere, C. (2003). Safer sex and reproductive choice: Findings from “Positive women: Voices and choices” in Zimbabwe. Reproductive Health Matters, 11(22), 162–173. doi: 10.1016/S0968-8080(03)02284-5.PubMedCrossRefGoogle Scholar
  18. Gilbert, N. (2008). Researching social life. Los Angeles: Sage Publications.Google Scholar
  19. Hoffman, L. W., & Hoffman, M. L. (1973). The value of children to parents. In J. T. Fawcett (Ed.), Psychological perspective on population (pp. 19–76). New York: Basic Books.Google Scholar
  20. Kanniappan, S., Jeyapaul, M. J., & Kalyanwala, S. (2008). Desire for motherhood: Exploring HIV-positive women’s desires, intentions and decision-making in attaining motherhood. AIDS Care, 20(6), 625–630. doi: 10.1080/09540120701660361.PubMedCrossRefGoogle Scholar
  21. Kline, A., Strickler, J., & Kempf, J. (1995). Factors associated with pregnancy and pregnancy resolution in HIV seropositive women. Social Science and Medicine, 40(11), 1539–1547. doi: 10.1016/0277-9536(94)00280-7.PubMedCrossRefGoogle Scholar
  22. Ko, N. Y., & Muecke, M. (2005). To reproduce or not: HIV-concordant couples make a critical decision during pregnancy. Journal of Midwifery & Women’s Health, 50(1), 23–30. doi: 10.1016/j.jmwh.2004.08.003.CrossRefGoogle Scholar
  23. Levine, C., & Dubler, N. N. (1990). Uncertain risks and bitter realities: The reproductive choices of HIV-infected women. The Milbank Quarterly, 68(3), 321–351. doi: 10.2307/3350109.PubMedCrossRefGoogle Scholar
  24. 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(4), 278–285. doi: 10.1089/apc.2006.0108.PubMedCrossRefGoogle Scholar
  25. Nakayiwa, S., Abang, B., Packel, L., Lifshay, J., Purcell, D. W., King, R., et al. (2006). Desire for children and pregnancy risk behavior among HIV-infected men and women in Uganda. AIDS and Behavior, 10, S95–S104. doi: 10.1007/s10461-006-9126-2.PubMedCrossRefGoogle Scholar
  26. Nebie, Y., Meda, N., Leroy, V., Mandelbrot, L., Yaro, S., Sombie, I., et al. (2001). Sexual and reproductive life of women informed of their HIV seropositivity: A prospective cohort study in Burkina Faso. Journal of Acquired Immune Deficiency Syndromes, 28(4), 367–372.PubMedGoogle Scholar
  27. Nobrega, A. A., Oliveira, F. A. S., Galvao, M. T. G., Mota, R. S., Barbosa, R. M., Dourado, I., et al. (2007). Desire for a child among women living with HIV/AIDS in northeast Brazil. AIDS Patient Care and STDs, 21(4), 261–267. doi: 10.1089/apc.2006.0116.PubMedCrossRefGoogle Scholar
  28. O’Rourke, A. (2005). Critical appraisal. In A. Bowling & S. Ebrahim (Eds.), Handbook of health research methods: Investigation, measurement and analysis (pp. 62–84). Maidenhead, England: Open University Press.Google Scholar
  29. Ogilvie, G. S., Palepu, A., Remple, V. P., Maan, E., Heath, K., MacDonald, G., et al. (2007). Fertility intentions of women of reproductive age living with HIV in British Columbia, Canada. AIDS (London, England), 21, S83–S88. doi: 10.1097/01.aids.0000255090.51921.60.Google Scholar
  30. Oosterhoff, P., Anh, N. T., Hanh, N. T., Yen, P. N., Wright, P., & Hardon, A. (2008). Holding the line: Family responses to pregnancy and the desire for a child in the context of HIV in Vietnam. Culture, Health & Sexuality, 10(4), 403–416. doi: 10.1080/13691050801915192.CrossRefGoogle Scholar
  31. Paiva, V., Filipe, E. V., Santos, N., Lima, T. N., & Segurado, A. (2003). The right to love: The desire for parenthood among men living with HIV. Reproductive Health Matters, 11(22), 91–100. doi: 10.1016/S0968-8080(03)02293-6.PubMedCrossRefGoogle Scholar
  32. Panozzo, L., Battegay, M., Friedl, A., & Vernazza, P. L. (2003). High risk behaviour and fertility desires among heterosexual HIV-positive patients with a serodiscordant partner—two challenging issues. Swiss Medical Weekly, 133(7–8), 124–127.PubMedGoogle Scholar
  33. Peltzer, K., Chao, L.-W., & Dana, P. (2008). Family planning among HIV positive and negative Prevention of Mother to Child Transmission (PMTCT) clients in a resource poor setting in South Africa. AIDS and Behavior, On-line journal article http://www.springerlink.com/content/p2031n27nu7t1323/fulltext.pdf (doi:  10.1007/s10461-008-9365-5).
  34. Richter, D. L., Sowell, R. L., & Pluto, D. M. (2002). Factors affecting reproductive decisions of African American women living with HIV. Women and Health, 36(1), 81–96. doi: 10.1300/J013v36n01_06.CrossRefGoogle Scholar
  35. Santos, N., Ventura-Filipe, E., & Paiva, V. (1998). HIV positive women, reproduction and sexuality in São Paulo, Brazil. Reproductive Health Matters, 6(12), 31–40. doi: 10.1016/S0968-8080(98)90005-2.CrossRefGoogle Scholar
  36. Sherr, L., & Barry, N. (2004). Fatherhood and HIV-positive heterosexual men. HIV Medicine, 5(4), 258–263. doi: 10.1111/j.1468-1293.2004.00218.x.PubMedCrossRefGoogle Scholar
  37. Siegel, K., & Schrimshaw, E. W. (2001). Reasons and justifications for considering pregnancy among women living with HIV/AIDS. Psychology of Women Quarterly, 25(2), 112–123. doi: 10.1111/1471-6402.00013.CrossRefGoogle Scholar
  38. Smith, D. J., & Mbakwem, B. C. (2007). Life projects and therapeutic itineraries: Marriage, fertility, and antiretroviral therapy in Nigeria. AIDS (London, England), 21, S37–S41. doi: 10.1097/01.aids.0000279705.24428.a3.Google Scholar
  39. Sonko, S. (1994). Fertility and culture in Sub-Saharan Africa: A review. International Social Science Journal, 46(3), 397–411.Google Scholar
  40. Sowell, R. L., & Misener, T. R. (1997). Decisions to have a baby by HIV-infected women. Western Journal of Nursing Research, 19(1), 56–70. doi: 10.1177/019394599701900104.PubMedCrossRefGoogle Scholar
  41. Sowell, R. L., Murdaugh, C. L., Addy, C. L., Moneyham, L., & Tavokoli, A. (2002). Factors influencing intent to get pregnant in HIV-infected women living in the southern USA. AIDS Care, 14(2), 181–191. doi: 10.1080/09540120220104695.PubMedCrossRefGoogle Scholar
  42. Sowell, R. L., Phillips, K. D., & Misener, T. R. (1999). HIV-infected women and motivation to add children to their families. Journal of Family Nursing, 5(3), 316–331. doi: 10.1177/107484079900500305.CrossRefGoogle Scholar
  43. Stanwood, N. L., Cohn, S. E., Heiser, J. R., & Pugliese, M. (2007). Contraception and fertility plans in a cohort of HIV-positive women in care. Contraception, 75(4), 294–298. doi: 10.1016/j.contraception.2006.12.012.PubMedCrossRefGoogle Scholar
  44. UNAIDS. (2007). AIDS epidemic update: December 2007. Geneva.Google Scholar
  45. Wesley, Y. (2003). Desire for children among Black women with and without HIV infection. Journal of Nursing Scholarship, 35(1), 37–43. doi: 10.1111/j.1547-5069.2003.00037.x.PubMedCrossRefGoogle Scholar
  46. Wesley, Y., Smeltzer, S. C., Redeker, N. S., Walker, S., Palumbo, P., & Whipple, B. (2000). Reproductive decision making in mothers with HIV-1. Health Care for Women International, 21(4), 291–304. doi: 10.1080/073993300245159.PubMedCrossRefGoogle Scholar
  47. Wright, R. W., Brand, R. A., Dunn, W., & Spindler, K. P. (2007). How to write a systematic review. Clinical Orthopaedics and Related Research, 455, 23–29. doi: 10.1097/BLO.0b013e31802c9098.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Barbara Nattabi
    • 1
  • Jianghong Li
    • 2
  • Sandra C. Thompson
    • 1
  • Christopher Garimoi Orach
    • 3
  • Jaya Earnest
    • 1
  1. 1.Centre for International Health and Curtin Health Innovation Research Institute, Faculty of Health SciencesCurtin University of TechnologyPerthAustralia
  2. 2.Centre for International Health/School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health SciencesCurtin University of TechnologyPerthAustralia
  3. 3.Department of Community Health and Behavioural SciencesMakerere University School of Public HealthKampalaUganda

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