Factors Associated With Repeat Pregnancy Among Women in an Area of High HIV Prevalence in Zimbabwe

Abstract

Background This study examined predictors of repeat pregnancy among women from the Prevention of Mother-to-Child Transmission of HIV (PMTCT) program in Zimbabwe. Methods The study was conducted at urban antenatal clinics in Chitungwiza, a high HIV prevalence urban town on the outskirts of Harare, Zimbabwe. Using a cross-sectional design, 79 HIV-positive and 80 HIV-negative women who had participated in a PMTCT program in their index pregnancy were interviewed in Shona using a standardized questionnaire 24 months after delivery of their index pregnancy. Logistic regression was used to determine whether a relationship exists between repeat pregnancy and HIV status, socioeconomic status, age, Fertility Attitude Score, and previous pregnancy outcomes. Results In multivariate analysis, factors associated with an increased likelihood of repeat pregnancy were death of a child (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.25–12.52; p = .0019), miscarriage (OR, 3.4; 95% CI, 1.23–9.34; p = .019), and each additional child (OR, 4.6; 95% CI, 1.89–11.52; p = .001). Decreased likelihood of repeat pregnancy was associated with decreased rank order of living conditions (OR, −0.75; 95% CI, 0.55–0.95; p = .021), each additional year of age (OR, −0.86; 95% CI, 0.77–0.97; p = .012), and higher Fertility Attitude Score (OR, −0.76; 95% CI, 0.64–0.91; p = .002). Conclusion HIV status alone was not significant as a predictor of repeat pregnancy. Women’s childbearing intentions are not influenced by the risk of mother-to-child transmission of HIV (MTCT) in this population. Future research is needed to address the cultural attitudes and sexual practices of HIV-positive women in order to minimize the threat of MTCT.