Journal of Reproductive Health, Gender, and HIV in Africa | 21 January 2004
Replication Study: Prevalence and Predictors of Fertility Intentions among Men Living with HIV in Johannesburg, South Africa
J, o, s, e, p, h, i, n, e, H, a, w, k, i, n, s, ,, A, n, a, t, h, i, B, o, t, h, a, ,, C, h, a, r, l, o, t, t, e, S, m, i, t, h
Abstract
Understanding fertility intentions among people living with HIV is essential for integrating reproductive health services into HIV care. An influential study from Johannesburg provided early insights into this issue among men. Given shifts in HIV treatment paradigms and social contexts, a replication study is needed to assess the contemporary relevance of the original findings. This study aimed to replicate a prior Johannesburg study to determine the current prevalence and predictors of fertility intentions among men living with HIV attending public sector antiretroviral therapy clinics in the same setting. A cross-sectional survey was conducted using a near-identical questionnaire to the original study. Men living with HIV were systematically sampled from comparable public clinics in Johannesburg. Data were analysed using descriptive statistics and multivariable logistic regression to identify predictors of fertility intentions. The prevalence of fertility intentions was 38%, higher than the 28% reported originally. Consistent with the original study, having a partner who desired a child remained the strongest predictor (adjusted odds ratio 4.2). However, current antiretroviral therapy use, a significant predictor in the original study, was not significant in this replication. Fertility intentions among men living with HIV in this setting are substantial and may have increased. While some core predictors are stable, others may have diminished in influence, possibly reflecting the normalisation of HIV as a chronic condition. HIV care programmes should routinely integrate sexual and reproductive health services, including counselling on safe conception. Further research should explore the reasons behind the observed increase in fertility intentions. fertility intentions, men, HIV, replication study, South Africa, reproductive health This direct methodological replication provides an updated evidence base for service planning and highlights the evolving nature of predictors within the context of improved HIV treatment.