title: Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study.
abstract: BACKGROUND
  Antiretroviral therapy has created new expectations in the possibilities of procreation for persons living with HIV. Our objectives were to evaluate reproductive desire and to analyze the associated sociodemographic and clinical factors in HIV-infected women in the Spanish AIDS Research Network Cohort (CoRIS).
  
  
  METHODS
  A mixed qualitative-quantitative approach was designed. Women of reproductive age (18-45) included in CoRIS were interviewed by phone, and data were collected between November 2010 and June 2012 using a specifically designed questionnaire. Reproductive desire was defined as having a desire to be pregnant at present or having unprotected sex with the purpose of having children or wanting to have children in the near future.
  
  
  RESULTS
  Overall, 134 women were interviewed. Median age was 36 years (IQR 31-41), 55% were Spanish, and 35% were unemployed. 84% had been infected with HIV through unprotected sex, with a median time since diagnosis of 4.5 years (IQR 2.9-6.9). Reproductive desire was found in 49% of women and was associated with: 1) Age (women under 30 had higher reproductive desire than those aged 30-39; OR = 4.5, 95% CI 1.4-14.3); 2) having no children vs. already having children (OR = 3.2; 1.3-7.7 3); Being an immigrant (OR = 2.2; 1.0-5.0); and 4) Not receiving antiretroviral treatment (OR = 3.6; 1.1-12.1). The main reasons for wanting children were related to liking children and wanting to form a family. Reasons for not having children were HIV infection, older age and having children already. Half of the women had sought or received information about how to have a safe pregnancy, 87% had disclosed their serostatus to their family circle, and 39% reported having experienced discrimination due to HIV infection.
  
  
  CONCLUSIONS
  The HIV-infected women interviewed in CoRIS have a high desire for children, and the factors associated with this desire are not fundamentally different from those of women in the general population. Maternity may even help them face a situation they still consider stigmatized and prefer not to disclose. Health-care protocols for handling HIV-positive women should incorporate specific interventions on sexual and reproductive health to help them fulfill their procreation desire and experience safe pregnancies.
authors.affiliation: Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Avda, Monforte de Lemos, 5 28029, Madrid, Spain. vhernando@isciii.es.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hernando
authors.forename: Belén
authors.initials: B
authors.lastname: Alejos
authors.forename: Débora
authors.initials: D
authors.lastname: Álvarez
authors.forename: Marta
authors.initials: M
authors.lastname: Montero
authors.forename: M Jesús
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Blanco
authors.forename: Mar
authors.initials: M
authors.lastname: Masiá
authors.forename: Jorge
authors.initials: J
authors.lastname: Del Romero
authors.forename: Ignacio
authors.initials: I
authors.lastname: de los Santos
authors.forename: Isabel
authors.initials: I
authors.lastname: Rio
authors.forename: Alicia
authors.initials: A
authors.lastname: Llácer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001240:Aspirations, Psychological; D054242:Emigrants and Immigrants / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D020073:Gravidity; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D033182:Intention; D008875:Middle Aged; D010353:Patient Education as Topic; D011247:Pregnancy / Q000523:psychology*; D013030:Spain; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents