Abstract
Tailoring sexual and reproductive health services to meet the needs of people living with the human immuno-deficiency virus (HIV) is a growing concern but there are few insights into these issues where HIV is most prevalent. This cross-sectional study investigated the fertility intentions and associated health care needs of 459 women and men, not sampled as intimate partners of each other, living with HIV in Cape Town, South Africa. An almost equal proportion of women (55%) and men (43%) living with HIV, reported not intending to have children as were open to the possibility of having children (45 and 57%, respectively). Overall, greater intentions to have children were associated with being male, having fewer children, living in an informal settlement and use of antiretroviral therapy. There were important gender differences in the determinants of future childbearing intentions, with being on HAART strongly associated with women’s fertility intentions. Gender differences were also apparent in participants’ key reasons for wanting children. A minority of participants had discussed their reproductive intentions and related issues with HIV health care providers. There is an urgent need for intervention models to integrate HIV care with sexual and reproduction health counseling and services that account for the diverse reproductive needs of these populations.
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Notes
The antenatal HIV prevalence was estimated to be approximately 29% in this residential area (personal communication, LG Bekker, Desmond Tutu HIV centre, University of Cape Town; 5th April 2006).
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Acknowledgments
This study was funded by the UNDP/UNFPA/WHO/World Bank Special Programme in Human Reproduction, World Health Organization (grant number A45100), the South African Medical Research Council and the University of Cape Town. We are grateful to the field staff, Nthuthu Manjezi and Pumeza Ngubane and to Penny Mgwigwi for data entry; to the Western Cape Provincial and City of Cape Town Health Departments; the health services where the study was conducted and participants. Our thanks to study consultants, Professors Zena Stein and Lesley Doyal and Dr Joanne Mantell as well as to Maria de Bruyn (Ipas, North Carolina) for insights on the subject and comments on the study instrument.
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Cooper, D., Moodley, J., Zweigenthal, V. et al. Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services. AIDS Behav 13 (Suppl 1), 38–46 (2009). https://doi.org/10.1007/s10461-009-9550-1
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DOI: https://doi.org/10.1007/s10461-009-9550-1