title: Pregnancy intent among a sample of recently diagnosed HIV-positive women and men practicing unprotected sex in Cape Town, South Africa.
abstract: BACKGROUND
  Sexual and reproductive health (SRH) services for HIV-positive women and men often neglect their fertility desires. We examined factors associated with pregnancy intent among recently diagnosed HIV-positive women (N = 106) and men (N = 91) who reported inconsistent condom use and were enrolled in an SRH intervention conducted in public sector HIV care clinics in Cape Town.
  
  
  METHODS
  Participants were recruited when receiving their first CD4 results at the clinic. All reported unprotected sex in the previous 3 months. Logistic regression identified predictors of pregnancy intent for the total sample and by gender.
  
  
  RESULTS
  About three fifths of men and one fifth of women reported intent to conceive in the next 6 months. In the full-sample multiple regression analysis, men [adjusted odds ratio (AOR = 6.62)] and those whose main partner shared intent to conceive (AOR = 3.80) had significantly higher odds of pregnancy intent; those with more years of education (AOR = 0.81) and more biological children (AOR = 0.62) had lower odds of intending pregnancy. In gender-specific analyses, partner sharing pregnancy intent was positively associated with intent among both men (AOR = 3.53) and women (AOR = 13.24). Among men, odds were lower among those having more biological children (AOR = 0.71) and those unemployed (AOR = 0.30). Among women, relying on hormonal contraception was negatively associated with intent (AOR = 0.08), and main partner knowing her HIV status (AOR = 5.80) was positively associated with intent to conceive.
  
  
  CONCLUSIONS
  Findings underscore the importance of providing integrated SRH services, and we discuss implications for clinical practice and care.
authors.affiliation: *Division of Gender, Sexuality and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY; †Women's Health Research Unit, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa; ‡Departments of Biostatistics and Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY; §Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa; ‖Epidemiology and Biostatistics Program, The City University of New York School of Public Health, Hunter College, New York, NY; ¶City of Cape Town Department of Health, Cape Town, South Africa; and #University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Exner
authors.forename: Diane
authors.initials: D
authors.lastname: Cooper
authors.forename: Dan
authors.initials: D
authors.lastname: Bai
authors.forename: Cheng-Shiun
authors.initials: CS
authors.lastname: Leu
authors.forename: Susie
authors.initials: S
authors.lastname: Hoffman
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moodley
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Kelvin
authors.forename: Debbie
authors.initials: D
authors.lastname: Constant
authors.forename: Karen
authors.initials: K
authors.lastname: Jennings
authors.forename: Virginia
authors.initials: V
authors.lastname: Zweigenthal
authors.forename: Zena A
authors.initials: ZA
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011247:Pregnancy / Q000523:psychology*; D015995:Prevalence; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents