Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114478

Carolyn Baek, MSC¹, Susan Kaai, MSc², Scott Geibel, MPH², Peter McOdida, BA³, Benson Ulo, MPH³, and Naomi Rutenberg, PhD¹. (1) Horizons, Population Council, 4301 Connecticut Ave, NW Suite 280, Washington, DC 20008, 202 237 9400, cbaek@pcdc.org, (2) Horizons, Population Council, P.O. Box 17643, Nairobi, Kenya, (3) International Medical Corps, East Africa Office, P.O Box 67513-00200, Nairobi, Kenya

Meeting HIV-positive women's sexual and reproductive health needs is an important element of family planning services within PMTCT programs. Moreover, preventing unintended pregnancy among HIV-positive women is an effective approach to reducing pediatric infection. Yet there is little data about HIV-positive women's fertility desires and demand for family planning.

In 2004, we interviewed 1235 (60 self-reported HIV-positive and 1175 HIV-negative women) at <10 weeks postpartum at six clinics in low-income areas in Nairobi. Mean number of children was 2.6 for HIV-positive and 2.1 for HIV-negative women. Intention to use contraception was similar (83% of HIV-positive and 90% of HIV-negative women). But HIV-positive women were significantly more likely to report not intending to have another child (82% vs. 36%, p<.0001).

We then conducted open-ended interviews with 24 HIV-positive women (mean number of children was 3.3) to learn about interaction with clinic providers, fertility desires, and demand for contraceptives. 20 out of 21 HIV-positive women who had received FP counseling received directive counseling, with the provider recommending contraceptive use. More than half of the women indicated providers advising their not having more children. When all 24 women were asked whether they wanted to have more children, 22 indicated no, with some using similar language they reported receiving from providers, as well as mentioning the need to take care of existing children. While multiple factors contribute to how a woman would decide to begin FP or which method to use, the most common responses were provider recommendation and HIV status/deteriorated health.

Learning Objectives:

• 1) Participants will learn about fertility desires by HIV status
• 2) Participants will learn about HIV-positive women’s demand for family planning
• 3) Participants will learn about factors that influence HIV-positive women’s decision making about family planning

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.