title: The importance of motherhood in HIV-positive women of reproductive age in Ontario, Canada.
abstract: Motherhood is personally, culturally, and historically rooted. Recent publications have focused on medical issues related to pregnancy and HIV, with attention on fetal well-being. There is limited literature on the importance of motherhood for HIV-positive women. Our study's purpose was to investigate the importance of motherhood among HIV-positive women of reproductive age in Ontario, Canada and to analyze the correlates thereof. We present our findings using a secondary analysis of cross-sectionally collected data from a study assessing fertility desires and intentions of HIV-positive women. The sub-analysis's outcome of interest was based on the question: "Being a mother is important to me" with a 5-point Likert scale that was dichotomized into strongly agree/agree vs. neutral/disagree/strongly disagree. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios (ORs) for significant correlates. Of the 497 respondents, median age was 38 (interquartile range [IQR] 32-43), 46% were African, 74% had given birth, and 57% intended to give birth. A total of 452 (91%) agreed (N = 75) or strongly agreed (N = 377) that being a mother was important to them. Age less than 40 years (OR 3.0; 95% confidence interval [CI] 1.6-5.7, African ethnicity (OR 9.2; 95% CI 3.2-26.3), immigration within 10 years (OR 19.6, 95% CI 4.6-83.1), and partner or family desire for a pregnancy (OR 3.3; 95% CI 1.5-7.3) were significant correlates of the importance of motherhood in a univariate analysis. Importance of motherhood was associated with desire (OR 6.2, 95% CI 3.1-12.3) and intention to give birth (OR 6.9, 95% CI 3.1-15.2), and previous birth (OR 8.5, 95% CI 4.2-16.8). In the multivariable model, the significant correlates were of age less than 40 years (OR 3.9; 95% CI 1.8-8.4), immigration within 10 years (OR 14.1; 95% CI 3.2-61.5), and having previously given birth (OR 11.2; 95% CI 5.1-24.4). The majority of women felt strongly that motherhood was important to them particularly among younger women, recent immigrants, and women who were mothers.
authors.affiliation: a Women's College Research Institute, Women's College Hospital , Toronto , Ontario , Canada.
authors.forename: V Logan
authors.initials: VL
authors.lastname: Kennedy
authors.forename: Lena
authors.initials: L
authors.lastname: Serghides
authors.forename: Janet M
authors.initials: JM
authors.lastname: Raboud
authors.forename: DeSheng
authors.initials: D
authors.lastname: Su
authors.forename: Sandra
authors.initials: S
authors.lastname: Blitz
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Hart
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Walmsley
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Angel
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Smaill
authors.forename: Edward D
authors.initials: ED
authors.lastname: Ralph
authors.forename: Wangari E
authors.initials: WE
authors.lastname: Tharao
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
mesh_terms: D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000523:psychology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D033182:Intention; D016015:Logistic Models; D008425:Maternal Behavior; D009042:Motivation; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D012098:Reproduction; D043762:Reproductive Behavior / Q000706:statistics & numerical data*