Abstract
IntroductionEvidence on childbearing desire and reproductive behaviors in women living with HIV on antiretroviral therapy (ART) is scarce, particularly in West Africa. We investigated the prevalence and associated factors of childbearing desire in HIV-infected women in care in Abidjan, Côte d’Ivoire and explored whether such desires were translated into behaviors related to contraceptive use and communication with health personnel.MethodsA cross-sectional survey was conducted in two HIV-care facilities in Abidjan, Côte d’Ivoire in 2015. Eligible women were non-pregnant, non-menopausal, aged 18–49 years and diagnosed as HIV-infected. The outcomes were childbearing desire, prevalence of modern contraceptive use, unmet needs for family planning and intention of the last pregnancy since HIV diagnosis. Women wishing to conceive immediately were asked whether they had discussed their desire with HIV healthcare workers. Logistic regression models were used to assess the associations between the outcomes and women’s characteristics.ResultsOf 1,631 women, 80% declared having childbearing desire. No association was found between women’s childbearing desire and ART status or its duration. In multivariate models, younger age, being in a stable relationship and having no or only one child were significantly associated with increased childbearing desire. Of the women wishing to conceive immediately (n = 713), only 43% reported having had fertility-related dialogue with healthcare provider. Among sexually active women wanting to avoid or delay pregnancy (n = 650), unmet needs for family planning was 40%. Regarding the last pregnancy since HIV diagnosis, one in three women reported not having wanted a baby at that time.ConclusionsPregnancy desire in women living with HIV in Abidjan was extremely high. Integration of safe conception strategies as well as improvement of contraceptive uptake among women in need of family planning are of utmost importance to ensure optimal conception and to avoid transmission of HIV to the male partner or to the forthcoming child.
Highlights
MethodsA cross-sectional survey was conducted in two HIV-care facilities in Abidjan, Cote d’Ivoire in 2015
Evidence on childbearing desire and reproductive behaviors in women living with HIV on antiretroviral therapy (ART) is scarce, in West Africa
Younger age, being in a stable relationship and having no or only one child were significantly associated with increased childbearing desire
Summary
A cross-sectional survey was conducted in two HIV-care facilities in Abidjan, Cote d’Ivoire in 2015. We conducted in 2015 a cross-sectional survey in two HIV-care facilities in Abidjan, Cote d’Ivoire, located in the most densely populated areas of the city, Treichville and Yopougon. These secondary-level facilities offer to patients routine clinical visits every three months with free of charge provision of ART. Reproductive health services were not routinely offered in any of these facilities, and patients were referred to counselors for family planning issues, either upon explicit request from patients themselves or clinical call made by health workers. In the communities surrounding these facilities, male condoms are accessible in pharmacies and other small shops
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