Childbearing intentions of HIV-positive women of reproductive age in Soweto, South Africa: the influence of expanding access to HAART in an HIV hyperendemic setting.
OBJECTIVE
We investigated whether the intention to have children varied according to HIV status and use of highly active antiretroviral therapy (HAART) among women in Soweto, South Africa.


METHODS
We used survey data from 674 women aged 18 to 44 years recruited from the Perinatal HIV Research Unit in Soweto (May through December 2007); 217 were HIV-positive HAART users (median duration of use = 31 months; interquartile range = 28, 33), 215 were HIV-positive and HAART-naive, and 242 were HIV negative. Logistic regression models examined associations between HIV status, HAART use, and intention to have children.


RESULTS
Overall, 44% of women reported intent to have children, with significant variation by HIV status: 31% of HAART users, 29% of HAART-naive women, and 68% of HIV-negative women (P < .001). In adjusted models, HIV-positive women were nearly 60% less likely to report childbearing intentions compared with HIV-negative women (for HAART users, adjusted odds ratio [AOR] = 0.40; 95% confidence interval [CI] = 0.23, 0.69; for HAART-naive women, AOR = 0.35; 95% CI = 0.21, 0.60), with minimal differences according to use or duration of HAART.


CONCLUSIONS
Integrated HIV, HAART, and reproductive health services must be provided to support the rights of all women to safely achieve their fertility goals.
Kaida
Angela
A
BC Centre for Excellence in HIV/AIDS and the School of Population and Public Health, University of British Columbia, Vancouver, Canada. akaida@interchange.ubc.ca
Laher
Fatima
F
Strathdee
Steffanie A
SA
Janssen
Patricia A
PA
Money
Deborah
D
Hogg
Robert S
RS
Gray
Glenda
G
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D015995:Prevalence; D043762:Reproductive Behavior / Q000523:psychology*; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
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