Fertility Desires and Intentions and the Relationship to Consistent Condom Use and Provider Communication Regarding Childbearing Among HIV Clients in Uganda

Published in: ISRN Infectious Diseases, v. 2013, Article ID 478192, 2013, 7 p

by Glenn Wagner, Rhoda K. Wanyenze

Read More

Access further information on this document at ISRN Infectious Diseases

This article was published outside of RAND. The full text of the article can be found at the link above.

Family planning services emphasize prevention of unplanned pregnancies, but rarely account for the childbearing desires of HIV clients. We examined the correlates of fertility desires and intentions among 767 HIV clients (34% male) starting antiretrovirals in Uganda. Half of participants had a primary sex partner. Among those with a desire (31%) or intention (24%) for having a child in the near future, 60% had not discussed this with providers. Over one quarter (27%) were told by their provider that they should not bear a child because of their HIV status. In regression analysis, male gender, younger age, higher CD4, having fewer children, and having a primary partner were associated with fertility desires and intentions; having been told by provider not to have a child was associated with intentions but not desires. Among participants with a primary partner, consistent condom use was greater among those with no fertility intentions, as was receipt of advise about family planning, while HIV disclosure to partner was greater among those with intentions. Partner HIV status was not associated with fertility desires or intentions. These findings highlight the need for reproductive health programs for HIV clients to incorporate safer conception counseling and improve communication regarding childbearing.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/research-integrity.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.