Fertility Desires among Women Living with HIV.
OBJECTIVE
Rates of pregnancy among women living with HIV (WLHIV) have increased with the availability of effective HIV treatment. Planning for pregnancy and childbirth is an increasingly important element of HIV care. Though rates of unintended pregnancies are high among women in general, among couples affected by HIV, significant planning and reproductive decisions must be considered to prevent negative health consequences for WLHIV and their neonates. To gain insight into this reproductive decision-making process among WLHIV, this study explored women's knowledge, attitudes and practices regarding fertility planning, reproductive desires, and safer conception practices. It was hypothesized that pregnancy desires would be influenced by partners, families, the potential risk of HIV transmission to infants, and physicians' recommendations.


METHODS
WLHIV of childbearing age were recruited from urban South Florida, and completed an assessment of demographics (N = 49), fertility desires and a conjoint survey of factors associated with reproductive decision-making.


RESULTS
Using conjoint analysis, we found that different decision paths exist for different types of women: Younger women and those with less education desired children if their partners wanted children; reproductive desires among those with less education, and with less HIV pregnancy-related knowledge, displayed a trend toward additional emphasis on their family's desires. Conversely, older women and those with more education appeared to place more importance on physician endorsement in their plans for childbearing.


CONCLUSIONS
Results of this study highlight the importance of ongoing preconception counselling for all women of reproductive age during routine HIV care. Counselling should be tailored to patient characteristics, and physicians should consider inclusion of families and/or partners in the process.
Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Deborah Lynne
http://orcid.org/0000-0002-4106-8891
DL
Jones
Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Ryan
R
Cook
Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
JoNell Efantis
JE
Potter
Ono Academic College, Kiryat Ono, Israel.|Center for Medicine in the Public Interest, New York, New York, United States of America.
Talya
T
Miron-Shatz
Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Nahida
N
Chakhtoura
Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Andrew
A
Spence
Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Margaret M
MM
Byrne
D000293:Adolescent; D000328:Adult; D003657:Decision Making; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D033182:Intention; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012747:Sexual Partners; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult