Since access to antiretroviral therapy has improved quality of life and survival for people living with HIV, many contemplate having children. But a study from Uganda indicates that being on antiretroviral therapy had little to no effect on the desire to have a child in the near future. The study did find that HIV-positive individuals who were of young age, were single or had lost some children were unlikely to desire a child in the near future.

Researchers interviewed 400 HIV-positive patients in southwestern Uganda. Three-fourths were women, 47 percent were aged 25-34 years, over 85 percent were currently married or had ever been married, and 62 percent had primary level of education or less. More than 17 percent had produced a child since the HIV diagnosis was made and 29 percent reported that they would like to have a child in the near future.

Fertility intentions among HIV-positive persons are more common in developing countries (where the overall fertility in the population is still high, contraceptive use is low and unmet need for contraception is high). Previous studies from Zambia and Zimbabwe have also found no effect of HIV diagnosis on subsequent childbearing, implying that pregnancy intentions were unaffected by HIV diagnosis.

“Identification of contextual determinants of decision to have children among HIV positive couples is useful for designing of policies and establishing intervention priorities in reproductive health for this population,” according to the study.

1. Kakaire O, Osinde MO, Kaye DK. Factors that predict fertility desires for people living with HIV infection at a support and treatment centre in Kabale, Uganda. Reproductive Health 2010; 7: 27. (open access)