Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
PLoS One. 2009 Dec 7;4(12):e7925. doi: 10.1371/journal.pone.0007925.
BACKGROUND: Improvements in life expectancy and quality of life for HIV-positive women coupled with reduced vertical transmission will likely lead numerous HIV-positive women to consider becoming pregnant. In order to clarify the demand, and aid with appropriate health services planning for this population, our study aims to assess the fertility desires and intentions of HIV-positive women of reproductive age living in Ontario, Canada. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study with recruitment stratified to match the geographic distribution of HIV-positive women of reproductive age (18-52) living in Ontario was carried out. Women were recruited from 38 sites between October 2007 and April 2009 and invited to complete a 189-item self-administered survey entitled "The HIV Pregnancy Planning Questionnaire" designed to assess fertility desires, intentions and actions. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios of significant predictors of fertility intentions. The median age of the 490 participating HIV-positive women was 38 (IQR, 32-43) and 61%, 52%, 47% and 74% were born outside of Canada, living in Toronto, of African ethnicity and currently on antiretroviral therapy, respectively. Of total respondents, 69% (95% CI, 64%-73%) desired to give birth and 57% (95% CI, 53%-62%) intended to give birth in the future. In the multivariable model, the significant predictors of fertility intentions were: younger age (age<40) (p<0.0001), African ethnicity (p<0.0001), living in Toronto (p = 0.002), and a lower number of lifetime births (p = 0.02). CONCLUSIONS/SIGNIFICANCE: The proportions of HIV-positive women of reproductive age living in Ontario desiring and intending pregnancy were higher than reported in earlier North American studies. Proportions were more similar to those reported from African populations. Healthcare providers and policy makers need to consider increasing services and support for pregnancy planning for HIV-positive women. This may be particularly significant in jurisdictions with high levels of African immigration.
背景：随着艾滋病毒阳性妇女预期寿命和生活质量的提高，以及垂直传播的减少，许多艾滋病毒阳性妇女可能会考虑怀孕。为了明确这一需求，并为这一人群提供适当的卫生服务规划，我们的研究旨在评估安大略省生育年龄的艾滋病毒阳性妇女的生育愿望和意图。
方法/主要发现：这是一项横断面研究，招募工作按生育年龄（18-52 岁）的艾滋病毒阳性妇女在安大略省的地理分布进行分层。2007 年 10 月至 2009 年 4 月期间，从 38 个地点招募妇女，并邀请她们完成一份名为“艾滋病毒妊娠计划问卷”的 189 项自我管理调查，旨在评估生育愿望、意图和行为。使用逻辑回归模型计算生育意图的显著预测因素的未调整和调整比值比。490 名参与的艾滋病毒阳性妇女的中位年龄为 38 岁（IQR，32-43），61%、52%、47%和 74%分别出生在加拿大以外、多伦多、非裔和正在接受抗逆转录病毒治疗。在总应答者中，69%（95%CI，64%-73%）希望生育，57%（95%CI，53%-62%）打算在未来生育。在多变量模型中，生育意图的显著预测因素为：年龄较小（<40 岁）（p<0.0001）、非裔（p<0.0001）、居住在多伦多（p=0.002）和一生生育次数较少（p=0.02）。
结论/意义：安大略省生育年龄的艾滋病毒阳性妇女的怀孕愿望和意图比例高于早期北美研究报告的比例。这些比例与来自非洲人群的报告更为相似。医疗保健提供者和政策制定者需要考虑为艾滋病毒阳性妇女的妊娠计划增加服务和支持。在非洲移民水平较高的司法管辖区，这可能尤为重要。
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