Determinants of Fertility Desires and Intentions among HIV Infected and Uninfected Women and Contraceptive use among HIV-infected women in the study atSix hospitals in two regions of Kenya

Abstract

HIV epidemic in Kenya is geographically diverse ranging from a prevalence of 26 percent and 0.4 percent. Evidence indicates that a higher proportion of HIV infected women are more likely to be associated with unintended pregnancies.Despite this evidence, little is known about determinants of fertility desires and intentions of HIVinfectedand HIV-uninfected women in Kenya. 437 HIV-infected and 365 HIV-uninfected women were enrolled in the study. Using a cross-sectional mixed method, the study sought to investigate determinants of fertility desires and intentions among HIV-infected and uninfected women, and further determined factors associated with desire and intention to use contraceptives among HIV-infected women. Focus group discussions and key informant interviews were conducted with HIV-infected and uninfected women and Health providers respectively. Sampling was proportionate to the size based on client volumes at each study hospital. Similar factors including; age, region ofresidence, place of residence, level of education, employment and marital status were found to significantly influence desire and intention to have children among HIV-infected and uninfected women. Older women were more likely to desire or intend to have more children P<0.001), marital status was the only factor that influenced desire and intention to utilize contraceptives among HIV-infected women. Myths and misconception and poor provider -client interactions on family planning methods were some of the demand and supply system gaps that hinder utilization of family planning methods Innovative approaches are required to promote use of contraceptives among HIV infected women to reduce maternal morbidity, mortality and vertical transmission of HIV.