The potential impact of antiretroviral therapy on fertility in sub-Saharan Africa.
Approximately 14 million women of child-bearing age are living with HIV/AIDS in sub-Saharan Africa. Women with HIV infection have between 25% and 40% lower fertility than noninfected women. As antiretroviral (ARV) therapy becomes increasingly accessible in sub-Saharan Africa, it is important to understand whether and how the associated clinical improvements correspond with changes in the incidence of pregnancy and fertility. Accordingly, this paper reviews the literature on the potential impact of ARV therapy on the fertility of women with HIV infection in sub-Saharan Africa. We use Bongaarts' proximate determinants of fertility framework (adapted for conditions of a generalized HIV epidemic) to examine the underlying mechanisms through which use of ARV therapy may impact the fertility of women with HIV infection. A conceptual framework is proposed to guide future research aimed at understanding how widespread use of ARV therapy may impact fertility in sub-Saharan Africa.
Kaida
Angela
A
Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, 5804 Fairview Avenue, Vancouver, British Columbia V6T 1Z3, Canada. akaida@interchange.ubc.ca
Andia
Irene
I
Maier
Marissa
M
Strathdee
Steffanie A
SA
Bangsberg
David R
DR
Spiegel
Jerry
J
Bastos
Francisco I
FI
Gray
Glenda
G
Hogg
Robert
R
D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003268:Contraception Behavior; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D005298:Fertility / Q000187:drug effects*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D017533:Marital Status; D011247:Pregnancy; D011256:Pregnancy Outcome
D019380:Anti-HIV Agents