title: The social legacy of AIDS: fertility aspirations among HIV-affected women in Uganda.
abstract: OBJECTIVE
  We investigated the impact of HIV status on fertility desires in Uganda.
  
  
  METHODS
  We surveyed 1594 women aged 18 to 49 years visiting outpatient services at Mbarara Regional Hospital, from May through August 2010. Of these, 59.7% were HIV-positive; 96.4% of HIV-positive women were using antiretroviral therapy (ART). We used logistic regression models to examine relationships between HIV status and fertility desires, marital status, household structure, educational attainment, and household income.
  
  
  RESULTS
  Among married women, HIV-positive status was significantly associated with a lower likelihood of desiring more children (27.7% vs 56.4% of HIV-negative women; χ(2) = 39.97; P < .001). The difference remained highly significant net of age, parity, son parity, foster children, education, or household income. HIV-positive women were more likely to be poor, unmarried, single heads of household, in second marriages (if married), living with an HIV-positive spouse, and supporting foster children.
  
  
  CONCLUSIONS
  We found a strong association between positive HIV status and lower fertility aspirations among married women in Uganda, irrespective of ART status. Although the increasing availability of ART is a tremendous public health achievement, women affected by HIV have numerous continuing social needs.
authors.affiliation: Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 41809, USA. rcsnow@umich.edu
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Snow
authors.forename: Massy
authors.initials: M
authors.lastname: Mutumba
authors.forename: Kenneth
authors.initials: K
authors.lastname: Resnicow
authors.forename: Godfrey
authors.initials: G
authors.lastname: Mugyenyi
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D005298:Fertility / Q000502:physiology*; D006679:HIV Seropositivity / Q000188:drug therapy / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D017533:Marital Status; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D043762:Reproductive Behavior / Q000523:psychology*; D012923:Social Class; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents