在卢旺达预期寿命提高的背景下，艾滋病毒阳性女性的生育意愿及相关因素
Prevalence and factors associated with fertility desire among HIV-positive women in Rwanda in the context of improved life expectancy.
作者信息
Niragire François, Ndikumana Celestin, Nyirahabimana Marie Gaudence, Uwizeye Dieudonne
机构信息
Department of Applied Statistics, University of Rwanda, Kigali, Rwanda.
Department of Governance and Public Administration, University of Rwanda, Kigali, Rwanda.
出版信息
Arch Public Health. 2021 Nov 25;79(1):209. doi: 10.1186/s13690-021-00742-w.
BACKGROUND
The knowledge of the key factors associated with fertility desire among people living with HIV/AIDS is crucial for the efficient planning of maternal and child health care programs. Fertility desire has generally increased among women of reproductive age in Rwanda. However, its level and determinants among women living with HIV/AIDS (WLHA) are currently not well known in the context of Rwanda. The present study aimed to fill in this knowledge gap.
METHODS
Data were extracted from the 2015 Rwanda demographic and health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable logistic regression analyses were conducted in order to identify the most influential factors.
RESULTS
The prevalence of desire to have another child in HIV-positive women was found to be as high as 40.7%. Multivariable logistic regression analyses showed that the woman's age of 35-49 years (AOR = 0.051, 95% CI: 0.013-0.204), woman's parity of 3 children or above (AOR = 0.177, 95% CI: 0.037-0.837), being employed (AOR = 0.298, 95% CI: 0.113-0.782) and currently using contraceptives (AOR = 0.146; 95% CI: 0.057-0.375) were significantly associated with low odds of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, or who were unemployed or who were not using any contraceptive were significantly associated with greater odds of desire to have another child than did other HIV- positive women. A woman whose partner's desire for children is different from hers was associated with about four times higher odds (AOR = 3.752; 95% CI: 1.203-11.702) of desire for more children than women who desire the same as their partners.
CONCLUSION
Fertility desire in WLHA is currently high in Rwanda. It is significantly influenced by demographic and socioeconomic factors. The Rwanda's health care system should be prepared to intensify the required services for the prevention of the vertical transmission of HIV, the delivery of maternal and child health care services, and the support to WLHA in planning their fertility. Interventions should target low-parity young women, with a particular focus on meeting their contraceptive needs.
背景
了解与艾滋病毒/艾滋病感染者生育意愿相关的关键因素，对于有效规划母婴保健项目至关重要。卢旺达育龄妇女的生育意愿总体呈上升趋势。然而，在卢旺达的背景下，艾滋病毒/艾滋病感染女性（WLHA）的生育意愿水平及其决定因素目前尚不清楚。本研究旨在填补这一知识空白。
方法
从2015年卢旺达人口与健康调查（RDHS）中提取了243名艾滋病毒呈阳性的育龄妇女的数据。进行单变量和多变量逻辑回归分析，以确定最具影响力的因素。
结果
发现艾滋病毒呈阳性的女性中想要再生育一个孩子的比例高达40.7%。多变量逻辑回归分析表明，年龄在35至49岁的女性（调整后比值比[AOR]=0.051，95%置信区间[CI]：0.013 - 0.204）、生育3个及以上孩子的女性（AOR = 0.177，95% CI：0.037 - 0.837）、就业女性（AOR = 0.298，95% CI：0.113 - 0.782）以及目前使用避孕药具的女性（AOR = 0.146；95% CI：0.057 - 0.375），与卢旺达艾滋病毒呈阳性女性生育意愿低的几率显著相关。年龄小于25岁、没有在世子女、失业或未使用任何避孕药具的女性，与其他艾滋病毒呈阳性女性相比，想要再生育一个孩子的几率显著更高。伴侣对生育子女的意愿与自己不同的女性，想要更多孩子的几率比与伴侣意愿相同的女性高出约四倍（AOR = 3.752；95% CI：1.203 - 11.702）。
结论
卢旺达艾滋病毒/艾滋病感染女性目前的生育意愿较高。它受到人口统计学和社会经济因素的显著影响。卢旺达的医疗保健系统应做好准备，加强预防艾滋病毒垂直传播所需的服务、提供母婴保健服务以及在生育规划方面为艾滋病毒/艾滋病感染女性提供支持。干预措施应针对低生育次数的年轻女性，特别关注满足她们的避孕需求。
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