Influences in fertility decisions among HIV-infected individuals in Lilongwe, Malawi: a qualitative study.
BACKGROUND
The motivation to have a child may be complex with numerous influencing factors, particularly among individuals living with HIV. This study sought to understand factors influencing fertility decision-making for HIV-infected men and women in Lilongwe, Malawi.


METHODS
Thirteen focus groups were conducted among HIV-infected individuals enrolled in antiretroviral treatment services.


RESULTS
Participants identified a hierarchy of influences in fertility decisions including the importance of childbearing, patriarchal influence, family influences and concern regarding HIV transmission.


CONCLUSIONS
Addressing fertility conversations beyond the confines of a relationship may be important, as family plays a significant role in fertility choices. Childbearing remains a fundamental desire among many individuals with HIV; however, concerns regarding transmission risk need to be addressed with efforts made to overcome misconception and assist individuals in balancing what may be competing influences.
Assistant Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA.
Lisa B
LB
Haddad
Graduate Student, Hubert Department of Global Health, Emory University, Atlanta, GA, USA.
Alexandra B
AB
Hoagland
Assistant Professor, Hubert Department of Global Health, Emory University, Atlanta, GA, USA.
Karen L
KL
Andes
Data Clerk, The Lighthouse Trust, Lilongwe, Malawi.
Bernadette
B
Samala
Research and Evaluation Advisor, International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA.
Caryl
C
Feldacker
Research Officer, Research for Equity and Community Health Trust (REACH) Trust, Lilongwe, Malawi.
Kingsley
K
Chikaphupha
Monitoring, Evaluation and Research Director, The Lighthouse Trust, Lilongwe, Malawi.
Hannock
H
Tweya
Clinical nurse, The Lighthouse Trust, Lilongwe, Malawi.
Jane
J
Chiwoko
Deputy Director, Reproductive Health Services, Ministry of Health, Lilongwe, Malawi.
Fannie
F
Kachale
Adjunct Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA.
Denise J
DJ
Jamieson
Executive Director, The Lighthouse Trust, Lilongwe, Malawi.
Sam
S
Phiri
Family planning; HIV; Malawi; fertility