Mekonnen Hussen, Enquselassie Fikre
Department of Nursing and Midwifery, School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Epidemiol Health. 2017 Jul 16;39:e2017028. doi: 10.4178/epih.e2017028. eCollection 2017.
With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia.
An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women.
Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women.
ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.
随着抗逆转录病毒疗法（ART）的普及，感染人类免疫缺陷病毒（HIV）的人比以前更能够考虑生育问题。在许多情况下，ART改变了他们的生育意愿。本研究旨在评估埃塞俄比亚亚的斯亚贝巴HIV阳性女性开始接受ART治疗12个月后生育意愿的变化。
在亚的斯亚贝巴对360名HIV阳性女性进行了一项基于机构的随访研究。采用逻辑回归模型评估社会人口统计学、生殖健康和临床特征对女性生育意愿变化的影响。
总体而言，40.8%（360名中的147名）女性在基线访视时表示希望未来生育一个孩子，而在12个月随访时有48.3%（360名中的174名）这样表示。开始接受ART治疗的女性中，报告在开始ART治疗12个月后希望生育一个孩子的比例（55.8%，190名中的106名）高于未接受过ART治疗的女性（40.0%，170名中的68名）。校正分析表明，基线和随访访视之间生育意愿的变化与ART使用（校正优势比[aOR]，2.47；95%置信区间[CI]，1.20至5.20）和婚姻状况显著相关，单身（aOR，5.33；95%CI，1.10至25.92）和已婚（aOR，6.35；95%CI，1.44至27.99）女性比离婚/丧偶女性更有可能报告有生育意愿。
ART使用是基线和随访访视之间生育意愿变化的一个重要预测因素，这表明需要做出更多努力将计划生育和HIV服务整合起来，以实现研究地区女性安全生育的目标。
