title: What is the relationship between increased access to HAART, relationship status and fertility decisions amongst HIV-positive women? A literature review and meta-analysis.
abstract: OBJECTIVE
  To investigate the relationship between fertility decisions, to have already had a child or to desire to have one in the future, and the prognostic factors; access to antiretrovirals, the time since these became widely available (year of the study); and relationship status.
  
  
  BACKGROUND
  There have been significant advances in the treatment of human immunodeficiency virus with the advent of antiretroviral therapy which has been used to successfully reduce the rate of mother to child transmission; leading researchers to hypothesise that human immunodeficiency virus-positive women may desire to have children more so now than in the past. However, this topic is often not discussed in healthcare consultations.
  
  
  METHODS
  A systematic search was conducted on Cumulative Index of Nursing and Allied Health Literature and Medline, using the key terms 'fertility decisions' and 'human immunodeficiency virus positive'. A meta-analysis of proportions and a meta-regression were conducted using a random-effects model and a logit transformation to normalise the data. Heterogeneity was assessed using Q, I2and R2values, and p-values were produced for each regressed variable.
  
  
  RESULTS
  There was no statistically significant relationship between a desire to have children in the future and any of the prognostic variables. However, there were statistically significant relationships between already having had at least one child; being on antiretroviral therapy; wanting a child in the future; and being in a cohabiting partnership or marriage.
  
  
  CONCLUSIONS
  There are no reliable prognostic variables which can be used to predict fertility intentions in human immunodeficiency virus-positive women. There is, however, a significant proportion of women who wish to have children or who have already had children and are in need of reproductive counselling from their healthcare providers.
  
  
  CONCLUSIONS
  A greater knowledge of factors which may influence reproductive decisions amongst human immunodeficiency virus-positive position will allow healthcare professionals to individualise the care they provide.
authors.affiliation: Guy's and St Thomas' Hospital, London, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Burgess
authors.affiliation: King's College London, London, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Purssell
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D003430:Cross-Sectional Studies; D003657:Decision Making; D005191:Family Characteristics; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000523:psychology; D006301:Health Services Needs and Demand; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011795:Surveys and Questionnaires
keywords: 
  HIV
  ; childbearing; fertility; pregnancy