Fertility among women living with HIV in western Ethiopia and its implications for prevention of vertical transmission: a cross-sectional study

ObjectiveThis study aimed to examine fertility (live births) in the last 3 years and its associated factors among women living with HIV (WLHIV) in western Ethiopia .DesignParticipants were recruited into a cross-sectional survey using systematic sampling.SettingsFour healthcare facilities in western Ethiopia were included.ParticipantsEligible participants were WLHIV of reproductive age (15–49 years) from western Ethiopia who found out about their HIV-positive status more than 3 years ago (N=866).Primary outcome measuresThe fertility (live births) of HIV-positive women in the last 3 years was surveyed using face-to-face interviews (March–June 2018). Logistic regression analyses were conducted to examine factors influencing fertility in the last 3 years.ResultsA total of 108 (12.5%) HIV-positive women gave birth to 121 live children in the last 3 years. Of these births, 18.2% were reported as mistimed at conception, while 26.4% were reported as unwanted. Of the live births, 8.3% ended in death. Of the 76 (62.8%) children with known HIV status born to HIV-positive women in the last 3 years, 7.9% were HIV-positive. In terms of predictors of fertility, women aged 15–24 years (adjusted OR (AOR) 2.72; 95% CI 1.14 to 6.49) and 25–34 years (AOR 4.34; 95% CI 2.61 to 7.21) had increased odds of fertility compared with women aged 35–49 years. Women using antiretroviral therapy (ART) for less than 5 years were more likely to have given birth in the last 3 years compared with those using ART for 10 years or more (AOR 2.96; 95% CI 1.19 to 7.36), even after controlling for age.ConclusionsWLHIV in Ethiopia are having children and so it is imperative that safe conception strategies are readily available as well as support to reduce HIV-related risks for children born to these mothers. Strengthening reproductive health services for HIV-positive women in order to achieve their family planning goals is therefore important.

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Study of Depression and Its Associated Factors among Women Living with HIV/AIDS in Coastal South India

ISRN AIDS ◽

10.5402/2012/684972 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

B. Unnikrishnan ◽

Vinita Jagannath ◽

John T. Ramapuram ◽

B. Achappa ◽

D. Madi

Keyword(s):

Rural Women ◽

South India ◽

Hiv Care ◽

Hiv Positive ◽

Chi Square ◽

Cross Sectional ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Living With Hiv ◽

Hiv Aids

Background. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals. Women with HIV are about four times more likely to be depressed than those who are not infected. Aims. To assess the sociodemographic and clinical correlates of depression among women living with HIV/AIDS. Setting and Design. One public and one private hospital in Mangalore, Coastal South India, and cross-sectional design. Methods and Materials. Study constituted of 137 HIV-positive women, depression was assessed using BDI (Beck Depression Inventory), and social support was assessed using Lubben Social Network Scale. Statistical Analysis. All analysis was conducted using SPSS version 11.5. Chi-square test with value less than 0.05 was taken as statistically significant. Results. Among 137 HIV-positive women, 51.1% were depressed. Around 16% were having moderate to high risk for isolation. Depression was statistically significant in rural women, widowed women, and lower socioeconomic class women. Conclusion. Depression is highly prevalent among women living with HIV which is still underdiagnosed and undertreated, and there is a need to incorporate mental health services as an integral component of HIV care.

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Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2021.3.6.1097 ◽

2021 ◽

Vol 3 (6) ◽

pp. 31-38

Author(s):

Isaac Maru ◽

Rose Olayo ◽

Mary Kipmerewo

Keyword(s):

Employment Status ◽

Target Population ◽

Hiv Positive ◽

Group Discussions ◽

Cross Sectional ◽

Negative Perception ◽

Number Of Children ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Living With Hiv

Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family.

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The Complexity of Work for Women who are HIV Positive: A Case Study in DKI Jakarta

Jurnal Perempuan ◽

10.34309/jp.v23i4.269 ◽

2018 ◽

Vol 23 (4) ◽

pp. 203

Author(s):

Andi Nur Faizah

Keyword(s):

Qualitative Method ◽

Family Members ◽

Hiv Positive ◽

Difficult Situation ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

And Gender ◽

Gender Categories ◽

Living With Hiv

The phenomenon of HIV-AIDS transmission places women in a difficult situation. The loss of family members such as husbands due to AIDS leaves women living with HIV positive in a struggle to access sources of livelihood. The condition of themselves as PLWHA, concerns about being stigmatized, caring for family members, and earning a living are the burdens of life they have to face. In this regard, this paper explores the complexity of the work of HIV-positive women. This study uses a qualitative method with a feminist perspective to get a complete picture of the livelihood of HIV-positive women. Based on interviews with five HIV-positive women, the findings found a link between social, identity, and gender categories that affect their livelihoods. HIV-positive women also transform themselves into their “normal” self by pretending to be healthy, able to work, have quality, and be independent. This is done as a form of resistance to the stigma attached to PLWHA.

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Fertility Desires and Family Size Preferences of HIV Positive Women Accessing Care in the University of Port Harcourt Teaching Hospital

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i1430512 ◽

2021 ◽

pp. 8-16

Author(s):

Awuri Babema-Igonikon ◽

Manuchimso Charles Akaninwor

Keyword(s):

Family Size ◽

Reproductive Age ◽

Systematic Sampling ◽

Hiv Positive ◽

High Fertility ◽

Significant Implication ◽

Fertility Desires ◽

Hiv Positive Women ◽

Desire To Have Children ◽

Port Harcourt

Introduction: Women living with HIV may or may not intend to bear children. They may also have different preferences in terms of family sizes. The desire of HIV positive women to bear children and their family size preferences has significant implication for horizontal and vertical transmission of this incurable disease. This study, therefore, aims to determine fertility preferences and their predictors among HIV positive women accessing care at UPTH, Port Harcourt, Rivers State. Methods: The study was a descriptive cross-sectional study among 402 women within the reproductive age (15-49 years) who were on Antiretroviral Therapy (ART). Participants were recruited using systematic sampling method and were interviewed with an interviewer-administered questionnaire. A semi-structured, self-administered questionnaire was used to obtain participant’s socio-demographic characteristics, desire for children, use, demand and choice of contraception and reproductive characteristics. With SPSS version 20, data was summarised as descriptive statistics and Chi-square test was used to test for association. Results: The study showed that 81.8% of respondents desire to have children out of which 96 (29.3%) desired one to two children, 169 (51.5%) desired three to four children, and 18 (5.5%) wanted five or more children. Factors such as age, marital status, and disclosure of Sero-status to partner were found to be associated with family size preferences (p<0.05). Conclusion: HIV positive women in Port Harcourt have high fertility desires and moderate family sizes preferences; thus, indicating the need for more support and involvement of the government and relevant stake holders in ensuring better access to ART services in the country. More resources should be channelled towards provision of effective preventive medications and services, people who live with HIV (PLHIVs) should be continuously and adequately sensitised with the necessary knowledge on how to make healthy reproductive decisions, as well as on available practicable reproductive options for HIV-infected women should be made efficient, and easily accessible.

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Prevalence and Determinants of Fertility Desire Among HIV-positive Women in Rwanda in the Context of Improved Life Expectancy: A Statistical Analysis of Cross-Sectional Data

10.21203/rs.3.rs-105991/v1 ◽

2020 ◽

Author(s):

François Niragire ◽

Celestin Ndikumana ◽

Marie Gaudence Nyirahabimana ◽

Dieudonne Uwizeye

Keyword(s):

Logistic Regression ◽

Scale Up ◽

Reproductive Age ◽

Hiv Positive ◽

Multivariable Logistic Regression Analysis ◽

People Living With Hiv ◽

Fertility Desire ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Hiv Positive Women

Abstract Background: The knowledge of the key determinants of fertility desire among people living with HIV/AIDS is crucial for the design of efficient maternal and child health care programs. However, such determinants are not well understood in the context of a successful scale-up of antiretroviral therapy in Rwanda. The present study aim was to assess fertility desire among HIV- positive women and its determinants in Rwanda.Methods: Data were extracted from the 2015 Rwanda demographic health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable based variable selection as well as multivariable logistic regression analysis were conducted. Results: The prevalence of desire to have another child in HIV-positive women was as high as 40.7%. Multivariable logistic regression analyses showed that the woman’s age, number of her living children, woman’s employment status, and having a co-wife are significant determinants of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, who were unemployed or who had at least a co-wife were associated with greater odds of desire to have another child in the future than other HIV- positive women.. Conclusion: There is a need to devise integrated programs and services that are tailored to support HIV-positive women in planning their fertility, and controlling HIV transmission to their prospective children. Efficient policy and fertility interventions among WLHA in Rwanda should target young women, especially those living with partners and have fewer children than they prefer.

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Predictive and spatial analysis for estimating the impact of sociodemographic factors on contraceptive use among women living with HIV/AIDS (WLWHA) in Kenya: Implications for policies and practice

BMJ Open ◽

10.1136/bmjopen-2018-022221 ◽

2019 ◽

Vol 9 (1) ◽

pp. e022221 ◽

Cited By ~ 1

Author(s):

Menkeoma Laura Okoli ◽

Samuel Alao ◽

Somtochukwu Ojukwu ◽

Nnadozie C Emechebe ◽

Asuelimen Ikhuoria ◽

...

Keyword(s):

Spatial Autocorrelation ◽

Contraceptive Use ◽

Wealth Index ◽

Sociodemographic Factors ◽

Hiv Positive ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Study Population ◽

Living With Hiv ◽

Hiv Aids

BackgroundDespite the availability and knowledge of various contraceptive methods, consistent utilisation in women living with HIV/AIDS (WLWHA) within the reproductive age group remains below the Sustainable Development Goals (SDGs) and Family Planning 2020 goals. This study examines the association between sociodemographic factors and contraceptive use including the effect of clustering tendencies of these factors on contraceptive usage among WLWHA in Kenya.MethodsWeighted multivariate logistic regression models were conducted to determine the association of sociodemographic factors on contraception use among WLWHA using the 2008–2009 Kenya Demographic Health Survey. Spatial autocorrelation techniques were used to explore clustering tendencies of these factors on contraception utilisation. Our study population included 304 HIV positive women, aged 15–49 years.ResultsAmong 304 HIV-positive women in our study population, 92 (30.3%) reported using one method of contraception. Contraceptive use was significantly associated with wealth and education after adjustment for other sociodemographic variables. Women classified as having low and middle wealth index were less likely to use contraceptives (OR=0.17, 95% CI 0.07 to 0.43; OR=0.33, 95% CI 0.11 to 0.98, respectively) compared with women classified as having high wealth index. Similarly, women with primary education only were less likely to use contraceptives compared with women with secondary or higher education (OR=0.42, 95% CI 0.18 to 0.98). Spatial autocorrelation revealed significant positive clusters with weak clustering tendencies of non-contraceptive use among different levels of wealth index and education within different regions of Kenya.ConclusionThese findings underscores the need for intervention programmes to further target socially disadvantaged WLWHA, which is necessary for achieving the SDGs.

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Reproductive Intentions of HIV-Positive Women on ARV Treatment in Abia State, Southeast Nigeria

ISRN Public Health ◽

10.1155/2014/593067 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Ijeoma Nduka ◽

Ezinna Ezinne Enwereji ◽

Enyinnaya C. Nduka ◽

Reginald Ahuizi Eke

Keyword(s):

Family Counseling ◽

University Teaching ◽

Systematic Sampling ◽

Hiv Positive ◽

African Culture ◽

Cross Sectional ◽

Hiv Positive Women ◽

Reproductive Intentions ◽

The Mean ◽

Living Children

Introduction. In the African culture, the primary reason for marriage is procreation. Every female strives to perform this role irrespective of her health status so as to fulfill part of the conditions for maintaining the marriage. The question is, to what extent are HIV-positive women aware of the risks of fulfilling this role? The study aimed to determine the reproductive intentions of HIV-positive women in Abia State. Materials and Methods. This was a longitudinal cross-sectional descriptive study conducted among married HIV-positive women attending the Heart to Heart treatment centre in Abia State University Teaching Hospital from February to October 2013. Systematic sampling was used to select 250 married women between the ages of 15–49 years who are on antiretroviral therapy. Interviewer administered questionnaire and focus group discussion were used to obtain relevant information from the participants. Data were analysed qualitatively and quantitatively. SPSS version 17 software was also used in the analyses. Results. The mean number of living children of the respondents was 2.3 ± 4.7. A good proportion of the respondents, 158 (63.7%) the desired to have more children. The younger the age group of the respondents (OR = 7.33), the lower their parity (OR = 3.69) and more regular they attended ARV clinic (OR = 47.76) the more they desired to have more children. The main reason for desiring more children was the quest to have male children. In the words of one respondent, “without a male child, the marriage is not secure. The woman can be chased out at any time.” Conclusion. The fact that a large proportion of HIV-positive women, irrespective of the mean number of living children and their gender, still desired to have more children shows poor knowledge of the risk they are exposed to by having large number of children. Family counseling/education on the benefits of using family planning devices especially condom is necessary for HIV-positive women and their male partners.

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Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017902016010059 ◽

2020 ◽

Vol 16 (1) ◽

pp. 59-66

Author(s):

Abdilahi Yousuf ◽

Ramli Musa ◽

Muhammad Lokman Md. Isa ◽

Siti Roshaidai Mohd Arifin

Keyword(s):

Cell Count ◽

Clinical Stage ◽

Public Hospitals ◽

Anxiety And Depression ◽

Hiv Positive ◽

Cd4 Cell Count ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Living With Hiv ◽

Cd4 Cell

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV. Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma. Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression. Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.

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Contraceptive Use and Method Preferences among HIV Positive Women in Ethiopia: A Systematic Review and Meta-analysis

BioMed Research International ◽

10.1155/2020/6465242 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Getnet Gedefaw ◽

Adam Wondmieneh ◽

Asmamaw Demis

Keyword(s):

Systematic Review ◽

Unintended Pregnancy ◽

Contraceptive Use ◽

Meta Analysis ◽

Hiv Positive ◽

Hiv Status ◽

Women Living With Hiv ◽

Modern Contraceptives ◽

Hiv Positive Women ◽

Living With Hiv

Background. Preventing unintended pregnancies among HIV positive women has a vital role to prevent mother to child transmission. Besides, increasing access to contraceptives has a number of economical importance and reducing the costs for mitigating the unintended pregnancy consequences. Therefore, this study is aimed at assessing the contraceptive use and method of preference among HIV positive women in Ethiopia. Methods. A systematic review and meta-analysis reporting guideline was applied. Articles searched from the Scopus, Pubmed/MEDLINE, EMBASE, AJOL, Hinari, and Google scholar were included in this review. The Stata 11 software was used to compute the analysis. Heterogeneity of the studies was detected using the Cochran Q test and I2 test statistics. Egger’s test was used to check the evidence of publication bias within the studies. Subgroup analysis and sensitivity analysis was computed with the evidence of heterogeneity. Results. Ten thousand one hundred twenty one (10121) women living with HIV/AIDS were recruited in this study. The national estimated prevalence of contraceptive use among HIV positive women in Ethiopia was 57.78% (95% CI: 48.53-67.03). Injectables and male condom were the most preferred contraceptives accounted for 36.00% (95% CI: 6.64-45.35) and 32.74% (95% CI: 21.08-44.40), respectively. Discussion with husband/partner (AOR: 4.70, 95% CI: 2.18-10.12), disclosure of HIV status to spouse/partner (AOR: 2.18, 95% CI: 1.55-3.06), ever counseled for modern contraceptives (AOR: 2.79, 95% CI: 2.01-3.88), attending secondary and above education (AOR: 3.12, 95% CI: 2.15-4.51), and having more than one live child (AOR: 2.61, 95% CI: 1.86-3.66) were increasing the likelihood of contraceptive use whereas not currently married women (AOR: 0.23, 95% CI: 0.16-0.34) was decreases the odds of contraceptive use. Conclusion. In Ethiopia, more than half of the women living with HIV/AIDS were using contraceptives. Discussion with husband/partner, disclosure of HIV status to spouse/partner, ever counseled for modern contraceptives, attending secondary and above education, and having more than one live child were increasing the uptake of contraceptives among HIV positive women. Partner discussion, having adequate information towards contraceptive use, and having desired number of child could increase the utilization; as a result, obstetric complication with HIV positive women due to unintended pregnancy is significantly decreasing.

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Unmet need for contraception among HIV-positive women in Ile-Ife, Nigeria

Tropical Doctor ◽

10.1177/0049475518809605 ◽

2018 ◽

Vol 49 (1) ◽

pp. 26-31

Author(s):

Temitope Omoladun Okunola ◽

Kayode T Ijaduola ◽

Ebunoluwa A Adejuyigbe

Keyword(s):

Unwanted Pregnancy ◽

Unmet Need ◽

Educational Status ◽

Cross Sectional Study ◽

Public Health Issue ◽

Hiv Positive ◽

Cross Sectional ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Unmet Need For Contraception

As mother-to-child transmission of HIV is difficult to predict and also hard to prevent in practice, pregnancy among women living with HIV/AIDS (WHA) needs to be taken with considerable aforethought. The prevention of unwanted pregnancy among WHA is therefore a public health issue. The aim of our study was to determine the unmet need for contraception among HIV-positive women and the associated factors. Ours was a cross-sectional study involving 425 non-pregnant WHA attending an adult HIV clinic in Nigeria. Interviewer-administered, structured questionnaires designed for the study were used to obtain data. The contraceptive uptake was 47% while the unmet need for contraception was 20%. There were significant associations between unmet need for contraception and age group ( P < 0.001), religion ( P < 0.001), ethnic group ( P < 0.001), knowledge about contraceptives ( P = 0.02), educational status ( P = 0.01) and partners’ retroviral status ( P = 0.008) The unmet need for contraception was high. Advocacy programs should perhaps be focused on older women, Christians and those with little or no education.

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