title: Impact of antiretroviral therapy on fertility desires among HIV-infected persons in rural Uganda.
abstract: BACKGROUND
  Little is known about the fertility desires of HIV infected individuals on highly active antiretroviral therapy (HAART). In order to contribute more knowledge to this topic we conducted a study to determine if HIV-infected persons on HAART have different fertility desires compared to persons not on HAART, and if the knowledge about HIV transmission from mother-to-child is different in the two groups.
  
  
  METHODS
  The study was a cross-sectional survey comparing two groups of HIV-positive participants: those who were on HAART and those who were not. Semi-structured interviews were conducted with 199 HIV patients living in a rural area of western Uganda. The desire for future children was measured by the question in the questionnaire "Do you want more children in future." The respondents' HAART status was derived from the interviews and verified using health records. Descriptive, bivariate and multivariate methods were used to analyze the relationship between HAART treatment status and the desire for future children.
  
  
  RESULTS
  Results from the multivariate logistic regression model indicated an adjusted odds ratio (OR) of 1.08 (95% CI 0.40-2.90) for those on HAART wanting more children (crude OR 1.86, 95% CI 0.82-4.21). Statistically significant predictors for desiring more children were younger age, having a higher number of living children and male sex. Knowledge of the risks for mother-to-child-transmission of HIV was similar in both groups.
  
  
  CONCLUSIONS
  The conclusions from this study are that the HAART treatment status of HIV patients did not influence the desire for children. The non-significant association between the desire for more children and the HAART treatment status could be caused by a lack of knowledge in HIV-infected persons/couples about the positive impact of HAART in reducing HIV transmission from mother-to-child. We recommend that the health care system ensures proper training of staff and appropriate communication to those living with HIV as well as to the general community.
authors.affiliation: Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada. walter.kipp@ualberta.ca
authors.forename: Walter
authors.initials: W
authors.lastname: Kipp
authors.forename: Jennifer
authors.initials: J
authors.lastname: Heys
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; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D033182:Intention; D008297:Male; D043762:Reproductive Behavior / Q000523:psychology*; D012423:Rural Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014454:Uganda; D055815:Young Adult