title: Perception of sexuality and fertility in women living with HIV: a questionnaire study from two Nordic countries.
abstract: BACKGROUND
  As the human immunodeficiency virus (HIV)-positive population ages, issues concerning sexuality and fertility, among others, are becoming relevant. HIV is still surrounded by stigma and taboos, and there have been few studies conducted in industrialized settings concerning these questions. We therefore wanted to investigate the perception of sexuality and fertility in women living with HIV (WLWH) in an industrialized setting, using a questionnaire.
  
  
  METHODS
  WLWH were recruited at their regular outpatient clinic visits, at the major Departments of Infectious Diseases in Denmark and Finland, from January 2012 to October 2013. A questionnaire was developed, study participants were informed of the nature of study and, if they agreed to participate and signed a consent form, they filled in the questionnaire. Demographic information on the participants was obtained from patient files (in Finland) or from a national HIV cohort (in Denmark). Statistical analysis was performed using STATA, version 11.
  
  
  RESULTS
  In total, 560 women were included in the study. The median age was 44 years. The majority were of white European origin, with fully suppressed HIV viral load, CD4 cell count >350 µL and mild or no symptoms of their HIV infection. A total of 62% were sexually active, stating condom use as their sole form of contraception. Of the sexually inactive women, one-third were in steady relationships. Eighty percent reported prior pregnancies, of which the majority had one or more children. Most children were born prior to the women's HIV diagnosis and the mode of conception was predominantly natural. One-quarter of the participating women desired pregnancy, while more than half did not. The remaining quarter either stated that they already had the desired number of children or chose not to answer the question. Fourteen percent stated that their HIV diagnosis ended their wish for children; of these women, the median time of diagnosis was between 1995 and 1996. Pregnancy had been attempted unsuccessfully in one-quarter of study participants. The final question inquired what the risk of mother-to-child transmission was, with all precautions taken. Fifteen percent estimated the risk to be above two percent.
  
  
  CONCLUSIONS
  In conclusion, the majority of WLWH in industrialized settings in Denmark and Finland have few HIV-related symptoms, are sexually active and have a strong desire for children.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; mariajwessman@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Wessman
authors.affiliation: Department of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Inka
authors.initials: I
authors.lastname: Aho
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Kristina
authors.initials: K
authors.lastname: Thorsteinsson
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Merete
authors.initials: M
authors.lastname: Storgaard
authors.affiliation: Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
authors.forename: Isik S
authors.initials: IS
authors.lastname: Johansen
authors.affiliation: Department of Pulmonary Medicine and Infectious Diseases, North Zealand Hospital, Hillerød, Denmark.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lunding
authors.affiliation: Department of InfectiousDiseases, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Pedersen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Anne-Mette
authors.initials: AM
authors.lastname: Lebech
authors.affiliation: Department of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Pia
authors.initials: P
authors.lastname: Kivelä
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Helleberg
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Terese L
authors.initials: TL
authors.lastname: Katzenstein
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.|Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Nina
authors.initials: N
authors.lastname: Weis
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D021841:Safe Sex; D012537:Scandinavian and Nordic Countries; D019529:Sexuality; D011795:Surveys and Questionnaires
keywords: HIV; fertility; questionnaire; sexuality; women