Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
AIDS. 2009 Nov;23 Suppl 1:S37-45. doi: 10.1097/01.aids.0000363776.76129.fd.
To determine how a positive HIV diagnosis influences fertility desires and reproductive decisions for women and men living in western Uganda.
: Cross-sectional survey comparing two groups of participants: those who tested HIV-positive and those who tested HIV-negative.
Semistructured interviews were conducted with 421 individuals living in rural areas. Descriptive, bivariate and multivariate methods were used to analyze the relationship of the HIV status to the desire to stop childbearing, reproductive decision-making and to the use of family planning methods.
The multivariate logistic regression model indicated that the odds ratio (OR) of wanting to stop childbearing was found to be 6.25 times greater (P < 0.01) for HIV-positive than for HIV-negative individuals. Additional predictors included older age (OR 1.13, P < 0.01), female sex (OR 2.42, P = 0.03), Mutooro ethnic group (OR 3.20, P < 0.01) and greater number of living children (OR 1.62, P < 0.01). Use of dual protection against HIV/sexually transmitted infection and unwanted pregnancy was rare in both groups with seven HIV-positive participants (3.5%) using two contraceptives compared with only one (0.4%) in the HIV-negative group. The unmet need for a highly effective family planning method was higher in HIV-positive participants compared with HIV-negative ones (90 vs. 78%).
HIV-positive individuals in the Kabarole region have a much greater desire to stop childbearing than their HIV-negative counterparts. The barriers to utilizing family planning services, as evidenced through the very low use of highly effective contraceptive methods, have to be jointly addressed by HIV/AIDS care/prevention and family planning programs.
确定乌干达西部的 HIV 阳性诊断如何影响女性和男性的生育愿望和生殖决策。
比较两组参与者的横断面调查：HIV 阳性组和 HIV 阴性组。
对 421 名生活在农村地区的个体进行半结构化访谈。采用描述性、双变量和多变量方法分析 HIV 状况与停止生育意愿、生殖决策以及计划生育方法使用的关系。
多变量逻辑回归模型表明，与 HIV 阴性个体相比，HIV 阳性个体想要停止生育的可能性要大 6.25 倍（P < 0.01）。其他预测因素包括年龄较大（OR 1.13，P < 0.01）、女性（OR 2.42，P = 0.03）、Mutooro 族裔（OR 3.20，P < 0.01）和更多的活产子女（OR 1.62，P < 0.01）。两组均很少使用双重保护措施来预防 HIV/性传播感染和意外怀孕，7 名 HIV 阳性参与者（3.5%）使用了两种避孕药具，而 HIV 阴性组只有 1 名（0.4%）。与 HIV 阴性参与者相比，HIV 阳性参与者对高效计划生育方法的需求未得到满足的比例更高（90%比 78%）。
卡巴莱地区的 HIV 阳性个体比 HIV 阴性个体更强烈地希望停止生育。必须由艾滋病毒/艾滋病护理/预防和计划生育方案共同解决利用计划生育服务的障碍，这一点可以从高效避孕方法的极低使用率得到证明。
