142nd APHA Annual Meeting and Exposition

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309148
Shifting Desires for Children within the Context of HIV/AIDS in Rakai, Uganda from 2001-2011

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Sanyukta Mathur, DrPH MHS , Department of Population & Family Health, Columbia University, Mailman School of Public Health, New York, NY
Tom Lutalo, MSc , Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
Ying Wei, PhD , Department of Biostatistics, Columbia University, New York, NY
Xiaobo Zhong, MS , Department of Biostatistics, Columbia University, New York, NY
John S. Santelli, MD, MPH , Department of Population and Family Health, Columbia University, New York, NY
Background: Generalized HIV epidemic, high fertility, and low contraceptive use settings provide an important impetus to examine fertility desire. We explored desire for children among HIV-positive and HIV-negative women within the context of a generalized HIV epidemic and HIV treatment availability in rural Uganda.

Methods: We used data from women aged 15-49 (n=42,195 person-rounds) from 2001-2011.  We examined trends in fertility desire and conducted regression analyses to estimate factors associated with desire for children.

Results: Women’s desire for children increased from 46% to 52% (p<0.0001). However the proportions of HIV-positive women desiring a or another child remained relatively stable across survey rounds even after the availability of HIV treatments and seem to be declining in recent rounds. HIV-positive women were less likely to desire children compared to HIV-negative women (OR: 0.39; 95% CI: 0.35-0.44). Being currently sexually active and being married was associated with increased desire for children; whereas desire dropped as women entered their 30s, if they already had one child, and if they were currently separated or widowed. Knowing about PMTCT or knowing someone who was on HIV treatments increased desire for children. However, a sub-analysis with HIV-positive women indicated that women who were on long-term HIV treatments had a decreased desire for children.

 

Conclusions: Being HIV-positive lowers women’s desire for children and being on treatment does not increase this desire. HIV care programs need to consider the family planning needs of HIV-positive women.

Learning Areas:

Assessment of individual and community needs for health education
Social and behavioral sciences

Learning Objectives:
Assess the desire for children among HIV-positive and HIV-negative women within the context of a generalized HIV epidemic and HIV treatment availability in rural Uganda.

Keyword(s): Women and HIV/AIDS, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-investigator of an NIH-funded grant to examine the linkages between reproductive health and HIV/AIDS. I also conducted my dissertation research on this topic, on the fertility desires among youth in rural Uganda.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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