title: Fertility intentions among HIV-infected, sero-concordant couples in Nyanza province, Kenya.
abstract: Research in sub-Saharan Africa has shown significant diversity in how HIV influences infected couples' fertility intentions. Supporting HIV-infected, sero-concordant couples in sub-Saharan Africa to make informed choices about their fertility options has not received sufficient attention. In-depth interviews were conducted among 23 HIV-positive, sero-concordant married couples in Kenya, to better understand how HIV impacted fertility intentions. HIV compelled many to reconsider fertility plans, sometimes promoting childbearing intentions in some individuals but reducing fertility plans among most, largely due to fears of early death, health concerns, stigma, perinatal HIV transmission and financial difficulties (particularly in men). Preferences for sons and large families influenced some couples' intentions to continue childbearing, although none had discussed their intentions with healthcare providers. Additional support and services for HIV-infected, sero-concordant couples are needed. Family planning counselling should be tailored to the unique concerns of HIV-infected couples, addressing perinatal transmission but also individual, couple-level and socio-cultural fertility expectations. Community-level programmes are needed to reduce stigma and make HIV-infected couples more comfortable in discussing fertility intentions with healthcare providers.
authors.affiliation: a Department of Anthropology , University of California , Los Angeles , USA.
authors.forename: Mellissa
authors.initials: M
authors.lastname: Withers
authors.forename: Shari
authors.initials: S
authors.lastname: Dworkin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Harrington
authors.forename: Zachary
authors.initials: Z
authors.lastname: Kwena
authors.forename: Maricianah
authors.initials: M
authors.lastname: Onono
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bukusi
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Newmann
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005191:Family Characteristics; D005193:Family Planning Services / Q000379:methods; D005260:Female; D005298:Fertility; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D033182:Intention; D007630:Kenya; D008297:Male; D043762:Reproductive Behavior / Q000523:psychology; D012938:Social Perception; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult