Dina Gurmesa Daba, Debelo Bikila Tefera, Belema Daniel, Danusa Kababa Temesgen, Muleta Rebuma
Midwifery Department, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia.
HIV AIDS (Auckl). 2021 Sep 24;13:927-938. doi: 10.2147/HIV.S328565. eCollection 2021.
Globally, the human immunodeficiency virus (HIV) affects young people in their reproductive years. Most of the studies conducted in Ethiopia focus on the fertility desire of women of reproductive age and did not give due consideration to the men's fertility perspective. Thus, this study aimed to assess the fertility desire, knowledge of prevention of mother to child of HIV (PMTCT), and associated factors among HIV-positive men and women attending ART clinic at west Shewa zone, Oromia region, Ethiopia, 2020.
Facility-based cross-sectional study design was applied to identify fertility desire, PMTCT knowledge, and associated factors among 590 HIV-positive reproductive age group men and women attending ART clinics at public health institutions of West Shewa zone. Data were collected by pre-tested structured questionnaires and analyzed using SPSS version 22. Binary logistic regression analysis was used to examine the association of predictors on fertility desire and knowledge about PMTCT. Odds ratio, 95% CI, and P value 0.05 were used to measure the statistical association.
The prevalence of fertility desire and knowledge of PMTCT in the study area were 58.8% and 30.7%, respectively. The odds of fertility desire were higher among the respondents aged >25 years [AOR=4.64, 95% CI (2.75-7.85)], housewives [AOR=3.14, 95% CI (1.90-5.21)], merchants [AOR=5.31, 95% CI (2.55-11.05)], ART use for ≤5 years [AOR=5.13, 95% CI (2.37-11.12)] and among those voluntarily tested to know their HIV status [AOR=2.16, 95% CI (1.30-3.58)]. Besides, the odds of fertility desire were low among husband who cannot read and write [AOR=0.07, 95% CI (0.02-0.23)], primary education [AOR=0.22, 95% CI (0.09-0.56)], and secondary education [AOR= 0.32, 95% CI (0.14-0.73)] when compared with husband education of college and above. Likewise, the odds of PMTCT knowledge were higher among the respondents aged less than 25 years [AOR=2.53, 95% CI (1.32-4.86)] who undergone voluntary testing during HIV diagnosis reasons [AOR=1.55, 95% CI (1.03-2.35)], and ART use for more than five years [AOR=1.94, 95% CI (1.26-2.98)].
Younger age, husband education, occupation, recent HIV test, and voluntary testing were significantly associated with fertility desire. Likewise, the younger age group, voluntary testing and counseling, and those on ART for more than five years had higher odds of PMTCT knowledge. Therefore, strengthening voluntary testing and counseling strong counseling on PMTCT throughout the follow-up care and involvement partners is of paramount importance should be insured to decrease MTCT.
在全球范围内，人类免疫缺陷病毒（HIV）影响处于生育年龄的年轻人。在埃塞俄比亚开展的大多数研究都聚焦于育龄女性的生育意愿，而未充分考虑男性的生育观点。因此，本研究旨在评估2020年埃塞俄比亚奥罗米亚州西谢瓦地区接受抗逆转录病毒治疗（ART）门诊治疗的HIV阳性男性和女性的生育意愿、预防母婴传播HIV（PMTCT）的知识及相关因素。
采用基于机构的横断面研究设计，以确定在西谢瓦地区公共卫生机构接受ART门诊治疗的590名HIV阳性育龄男性和女性的生育意愿、PMTCT知识及相关因素。通过预先测试的结构化问卷收集数据，并使用SPSS 22版进行分析。二元逻辑回归分析用于检验预测因素与生育意愿及PMTCT知识之间的关联。比值比、95%置信区间和P值0.05用于衡量统计关联。
研究地区的生育意愿患病率和PMTCT知识知晓率分别为58.8%和30.7%。年龄>25岁的受访者生育意愿的几率更高[AOR=4.64，95%置信区间(2.75 - 7.85)]，家庭主妇[AOR=3.14，95%置信区间(1.90 - 5.21)]，商人[AOR=5.31，95%置信区间(2.55 - 11.05)]，接受ART治疗≤5年[AOR=5.13，95%置信区间(2.37 - 11.12)]以及自愿检测以了解自身HIV状况的人群[AOR=2.16，95%置信区间(1.30 - 3.58)]。此外，与大学及以上学历的丈夫相比，不识字的丈夫[AOR=0.07，95%置信区间(0.02 - 0.23)]、小学学历[AOR=0.22，95%置信区间(0.09 - 0.56)]和初中学历[AOR=0.32，95%置信区间(0.14 - 0.73)]的丈夫生育意愿的几率较低。同样，年龄小于25岁的受访者[AOR=2.53，95%置信区间(1.32 - 4.86)]、因HIV诊断原因接受过自愿检测的人群[AOR=1.55，95%置信区间(1.03 - 2.35)]以及接受ART治疗超过五年的人群[AOR=1.94，95%置信区间(1.26 - 2.98)]，其PMTCT知识知晓率的几率更高。
年龄、丈夫的教育程度、职业、近期HIV检测以及自愿检测与生育意愿显著相关。同样，年龄较小的群体、自愿检测与咨询以及接受ART治疗超过五年的人群，其PMTCT知识知晓率的几率更高。因此，在整个后续护理过程中加强自愿检测和咨询，并确保伴侣的充分参与，对于加强PMTCT咨询以降低母婴传播至关重要。
