Inserm, UMR 1219, Bordeaux Population Health Research Center, Team IDLIC, French National Research Institute for Sustainable Development (IRD), University of Bordeaux, Bordeaux, France.
Programme PAC-CI, ANRS site in Côte d'Ivoire, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.
PLoS One. 2020 Oct 21;15(10):e0239859. doi: 10.1371/journal.pone.0239859. eCollection 2020.
Evidence on childbearing desire and reproductive behaviors in women living with HIV on antiretroviral therapy (ART) is scarce, particularly in West Africa. We investigated the prevalence and associated factors of childbearing desire in HIV-infected women in care in Abidjan, Côte d'Ivoire and explored whether such desires were translated into behaviors related to contraceptive use and communication with health personnel.
A cross-sectional survey was conducted in two HIV-care facilities in Abidjan, Côte d'Ivoire in 2015. Eligible women were non-pregnant, non-menopausal, aged 18-49 years and diagnosed as HIV-infected. The outcomes were childbearing desire, prevalence of modern contraceptive use, unmet needs for family planning and intention of the last pregnancy since HIV diagnosis. Women wishing to conceive immediately were asked whether they had discussed their desire with HIV healthcare workers. Logistic regression models were used to assess the associations between the outcomes and women's characteristics.
Of 1,631 women, 80% declared having childbearing desire. No association was found between women's childbearing desire and ART status or its duration. In multivariate models, younger age, being in a stable relationship and having no or only one child were significantly associated with increased childbearing desire. Of the women wishing to conceive immediately (n = 713), only 43% reported having had fertility-related dialogue with healthcare provider. Among sexually active women wanting to avoid or delay pregnancy (n = 650), unmet needs for family planning was 40%. Regarding the last pregnancy since HIV diagnosis, one in three women reported not having wanted a baby at that time.
Pregnancy desire in women living with HIV in Abidjan was extremely high. Integration of safe conception strategies as well as improvement of contraceptive uptake among women in need of family planning are of utmost importance to ensure optimal conception and to avoid transmission of HIV to the male partner or to the forthcoming child.
在接受抗逆转录病毒疗法（ART）的艾滋病毒感染者中，有关生育意愿和生殖行为的证据很少，尤其是在西非。我们调查了科特迪瓦阿比让的艾滋病毒感染者中生育意愿的流行情况及其相关因素，并探讨了这些意愿是否转化为与避孕使用和与卫生人员沟通相关的行为。
2015 年在科特迪瓦阿比让的两家艾滋病毒护理机构进行了一项横断面调查。合格的妇女是非孕妇、非绝经、年龄在 18-49 岁之间，被诊断为艾滋病毒感染。结果是生育意愿、现代避孕方法的使用流行率、计划生育的未满足需求以及自艾滋病毒诊断以来的最后一次怀孕意图。希望立即怀孕的妇女被问及她们是否与艾滋病毒保健工作者讨论过她们的愿望。使用逻辑回归模型评估了结局与妇女特征之间的关联。
在 1631 名妇女中，80%表示有生育意愿。妇女的生育意愿与 ART 状况或其持续时间之间没有关联。在多变量模型中，年龄较小、处于稳定关系中、没有或只有一个孩子与生育意愿增加显著相关。在希望立即怀孕的妇女中（n=713），只有 43%报告与医疗保健提供者进行了与生育力相关的对话。在希望避免或延迟怀孕的有性行为的妇女中（n=650），计划生育的未满足需求为 40%。关于自艾滋病毒诊断以来的最后一次怀孕，三分之一的妇女报告说当时并不想要孩子。
在阿比让的艾滋病毒感染者中，怀孕的愿望非常强烈。整合安全受孕策略以及改善有计划生育需求的妇女的避孕措施的采用率，对于确保最佳受孕并避免艾滋病毒传播给男性伴侣或即将出生的孩子至关重要。
