Fertility Desires and Intentions of HIV-Positive Patients
In spite of the staggering population of over 120 million people in Nigeria, the current total fertility rate of 5.7 ranks among the highest in the world. The complex relationship between fertility and HIV/AIDS threatens the preventive strategies against the HIV (treating HIV infection) epidemic in countries like Nigeria, where the fertility rate is still high and access to antiretroviral therapy remains poor. Due to advances in drug treatment and improved health status of HIV-infected individuals in the developed countries, fertility issues among them have taken a new turn in the last few years. Chen et al. showed that up to 28-29% of HIV-infected men and women receiving treatment in the United States desire children in the future. In a similar study in Switzerland, 38% of HIV-positive men and 45% of HIV-positive women expressed the desire for child-bearing. More than for others, reproducing (or “giving life”) for HIV-positive individuals means transcending the death that appears near, and these figures may be much higher in low-resource settings, where the disease prognosis is still very poor.
Although the desire of HIV-infected persons to have children has important implications for the transmission of the virus to their sexual partners and newborns, HIV-positive status has not been shown to significantly influence childbearing. Studies conducted in southern Africa indicated that the fertility levels of HIV-positive individuals were not greatly influenced by their understanding of the risks of HIV infection (treating HIV infection) to their partners and children. This situation is further compounded by the negative attitudes of health professionals towards childbearing by people living with HIV (treating HIV infection), which has continually raised questions on protection of their reproductive rights. In order to assist these individuals to achieve their fertility goals without jeopardizing their own health or that of others, accurate information on their fertility desires and intentions is essential. To the best of our knowledge, there is no published study in Nigeria that has addressed fertility issues among the HIV-infected population. Besides, recent clinical audit meetings in our center indicated an increasing number of pregnancies among our HIV-positive patients, and this called for an investigation. It is against this background that we conducted a survey among HIV-positive patients receiving care at a Nigerian specialist clinic to assess the extent of their fertility desires and intentions and explore how these may vary by individual’s sociodemographic and health-related factors. The findings would enable us to understand other reproductive health needs of the HIV-positive Nigerians besides their physical health demands.