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HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study.

Publication ,  Journal Article
Ayieko, J; Ti, A; Hagey, J; Akama, E; Bukusi, EA; Cohen, CR; Patel, RC
Published in: Reprod Health
August 8, 2017

BACKGROUND: Factors influencing fertility desires among HIV-infected individuals remain poorly understood. With new recommendations for universal HIV treatment and increasing antiretroviral therapy (ART) access, we sought to evaluate how access to early ART influences fertility desires among HIV-infected ART-naïve women. METHODS: Semi-structured in-depth interviews were conducted with a select subgroup of 20 HIV-infected ART-naïve women attending one of 13 HIV facilities in western Kenya between July and August 2014 who would soon newly become eligible to initiate ART based on the latest national policy recommendations. The interviews covered four major themes: 1) definitions of family and children's role in community; 2) personal, interpersonal, institutional, and societal factors influencing fertility desires; 3) influence of HIV-positive status on fertility desires; and 4) influence of future ART initiation on fertility desires. An iterative process of reading transcripts, applying inductive codes, and comparing and contrasting codes was used to identify convergent and divergent themes. RESULTS: The women indicated their HIV-positive status did influence-largely negatively-their fertility desires. Furthermore, initiating ART and anticipating improved health status did not necessarily translate to increased fertility desires. Instead, individual factors, such as age, parity, current health status, financial resources and number of surviving or HIV-infected children, played a crucial role in decisions about future fertility. In addition, societal influences, such as community norms and health providers' expectations of their fertility desires, played an equally important role in determining fertility desires. CONCLUSIONS: Initiating ART may not be the leading factor influencing fertility desires among previously ART-naïve HIV-infected women. Instead, individual and societal factors appear to be the major determinants of fertility desires among these women.

Duke Scholars

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Published In

Reprod Health

DOI

EISSN

1742-4755

Publication Date

August 8, 2017

Volume

14

Issue

1

Start / End Page

93

Location

England

Related Subject Headings

  • Women
  • Socioeconomic Factors
  • Qualitative Research
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans
  • HIV Infections
  • Female
  • Family Planning Services
 

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Ayieko, J., Ti, A., Hagey, J., Akama, E., Bukusi, E. A., Cohen, C. R., & Patel, R. C. (2017). HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study. Reprod Health, 14(1), 93. https://doi.org/10.1186/s12978-017-0355-9
Ayieko, James, Angeline Ti, Jill Hagey, Eliud Akama, Elizabeth A. Bukusi, Craig R. Cohen, and Rena C. Patel. “HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study.Reprod Health 14, no. 1 (August 8, 2017): 93. https://doi.org/10.1186/s12978-017-0355-9.
Ayieko, James, et al. “HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study.Reprod Health, vol. 14, no. 1, Aug. 2017, p. 93. Pubmed, doi:10.1186/s12978-017-0355-9.
Journal cover image

Published In

Reprod Health

DOI

EISSN

1742-4755

Publication Date

August 8, 2017

Volume

14

Issue

1

Start / End Page

93

Location

England

Related Subject Headings

  • Women
  • Socioeconomic Factors
  • Qualitative Research
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans
  • HIV Infections
  • Female
  • Family Planning Services