The Relationship between Viral Load Status and Fertility Intentions of HIV-Positive Women of Reproductive Ages in Addis Ababa: A Facility Based Cross-Sectional Study

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Date

2022-07-20

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Addis Ababa University

Abstract

Back ground: People living with HIV/AIDS (PLHIV), like everyone else, want and intend to have children. Although the fertility impact of HIV is already well acknowledged, women’s fertility behaviors could also largely be influenced by the level of their viral loads. Being sexually active and not taking contraception, women who never became pregnant had greater HIV viral loads. Objectives: to assess the relationship between viral load status and fertility intentions of HIV positive women of reproductive ages in six selected public health hospitals, in Addis Ababa, Ethiopia. Methods: A sample size of 432 reproductive ages HIV-positive women who got ART service at selected public hospitals were interviewed. A binary logistic regression analysis was used to assess the relationship between viral load status and fertility intention. Results: Of the total respondents, 196 (45.4%) had intention to give birth within the coming 3 years, while the remaining 236 (54.6) had no intention. Fertility intention was 2.71 times higher among women of ages 25-34 compared to age > 34 years (95% CI: 1.005-7.339). Moreover, married women had fertility intention 6.06 times higher (95% CI: 1.12-32.7) compared to widowed women. Further, fertility was higher among women who knew their partner HIV status. Intention was 5.63 times higher (95% CI: 0.846-37.484) and 19.28 times higher (95% CI: 2.533- 148.326) among women who knew their partner HIV status to be positive and negative respectively, compared to those with no knowledge of their HIV status. On the other hand, fertility intention decreased for women with no formal education and primary by 95.1 (95% CI: 0.010- 0.252) and 83.9 (95% CI: 0.039-0.662), respectively compared to secondary and above level of education. For women who believed they have enough number of children; the odds of fertility intention decreased by 99.7 (95% CI: 0.001-0.011). Further, the odds of fertility intention of women who made decision on pregnancy or contraceptive use alone were lower by 71.5% compared to those who jointly made the decision. Conclusion and Recommendation: - A high proportion of HIV positive reproductive ages women desire to conceive. However, the finding witnessed that there was no significant association between viral load status and fertility intention. Beside that there were no fertility differentials between women who have undetectable and detectable viral loads. The findings strongly implicate the need for strengthening and proper implementation of the various health policies and guidelines pertaining to HIV/AIDS for increased uptake of reproduction health services by PLHIV women. The government and other stakeholders should reach young women including sexually active with HIV prevention, testing and treatment services.

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Keywords

fertility intention, viral loads, undetectable/detectable, durable viral suppression

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