title: Fertility desires and infection with the HIV: results from a survey in rural Uganda.
abstract: OBJECTIVE
  To determine how a positive HIV diagnosis influences fertility desires and reproductive decisions for women and men living in western Uganda.
  
  
  METHODS
  : Cross-sectional survey comparing two groups of participants: those who tested HIV-positive and those who tested HIV-negative.
  
  
  METHODS
  Semistructured interviews were conducted with 421 individuals living in rural areas. Descriptive, bivariate and multivariate methods were used to analyze the relationship of the HIV status to the desire to stop childbearing, reproductive decision-making and to the use of family planning methods.
  
  
  RESULTS
  The multivariate logistic regression model indicated that the odds ratio (OR) of wanting to stop childbearing was found to be 6.25 times greater (P < 0.01) for HIV-positive than for HIV-negative individuals. Additional predictors included older age (OR 1.13, P < 0.01), female sex (OR 2.42, P = 0.03), Mutooro ethnic group (OR 3.20, P < 0.01) and greater number of living children (OR 1.62, P < 0.01). Use of dual protection against HIV/sexually transmitted infection and unwanted pregnancy was rare in both groups with seven HIV-positive participants (3.5%) using two contraceptives compared with only one (0.4%) in the HIV-negative group. The unmet need for a highly effective family planning method was higher in HIV-positive participants compared with HIV-negative ones (90 vs. 78%).
  
  
  CONCLUSIONS
  HIV-positive individuals in the Kabarole region have a much greater desire to stop childbearing than their HIV-negative counterparts. The barriers to utilizing family planning services, as evidenced through the very low use of highly effective contraceptive methods, have to be jointly addressed by HIV/AIDS care/prevention and family planning programs.
authors.affiliation: Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Heys
authors.forename: Walter
authors.initials: W
authors.lastname: Kipp
authors.forename: Gian S
authors.initials: GS
authors.lastname: Jhangri
authors.forename: Arif
authors.initials: A
authors.lastname: Alibhai
authors.forename: Tom
authors.initials: T
authors.lastname: Rubaale
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000523:psychology*; D003430:Cross-Sectional Studies; D005193:Family Planning Services; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D015497:HIV-1; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011247:Pregnancy; D043762:Reproductive Behavior / Q000208:ethnology / Q000523:psychology*; D012423:Rural Health; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult