title: Factors associated with intention to conceive and its communication to providers among HIV clients in Uganda.
abstract: Persons living with HIV/AIDS (PLHA) must discuss their fertility intentions with healthcare providers to receive the support needed to have children safely and limit transmission risks. However, few quantitative studies have examined correlates of fertility intentions, let alone the communication of such intentions with providers. We examined the prevalence and correlates of intentions to have children, and comfort discussing such plans with one's providers, in HIV clients at two HIV clinics in Uganda. Cross-sectional self-report data were collected from 233 patients who had primary partners. Bivariate correlates significant at the P < 0.10 level were included in logistic regression analysis. Of the 233 participants, 103 (44%) reported an intention to conceive a child in the near future. In multivariate analysis, younger age of both the patient and their partner, better physical health functioning and higher internalized HIV stigma were associated with having fertility intentions. One-third (35%) of those with fertility intentions expressed having difficulty discussing these intentions with their providers, which was associated with receiving care at the rural clinic and greater internalized HIV stigma. These findings highlight the need for reproductive health services that help clients accept themselves as PLHA and their fertility rights, thus promoting patient-doctor communication needed to promote safe child conception and delivery outcomes.
authors.affiliation: RAND, Santa Monica, CA, USA. gwagner@rand.org
authors.forename: Glenn
authors.initials: G
authors.lastname: Wagner
authors.forename: Sebastian
authors.initials: S
authors.lastname: Linnemayr
authors.forename: Cissy
authors.initials: C
authors.lastname: Kityo
authors.forename: Peter
authors.initials: P
authors.lastname: Mugyenyi
mesh_terms: D000328:Adult; D000367:Age Factors; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012098:Reproduction; D043762:Reproductive Behavior; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult