Proportion and factors associated with fertility desires among human immuno deficiency virus positive adults receiving antiretroviral therapy in Northeast Ethiopia

Abel Endawkie^1*Biresaw Derese²Kidist Adamu³Getaw Walle¹

• ¹Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
• ²Public Health, Zemen Post Graduate College, Dessie, Ethiopia, Dessie, Ethiopia
• ³Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia, Dessie, Ethiopia

The desire to have children can become a significant consideration for many people living with HIV (PLHIV), both men and women, particularly as access to antiretroviral therapy (ART) is increased and the rates of mother-to-child transmission (MTCT) decline. Nevertheless, research on fertility desires among this demographic remains sparse, especially in Northeast Ethiopia. This study aims to assess the proportion of fertility desires and identify the associated factors among HIV-positive adults receiving care in ART units in Northeast Ethiopia.A cross-sectional study was conducted from May 15 to June 15, 2022, among 406 individuals living with HIV who were receiving ART in the Meket District of Northeast Ethiopia. Participants were selected through systematic random sampling. Data were collected using self-administered questionnaires. Data entry and analysis were performed using EpiData version 3.1 and Stata version 14.0, respectively. Multivariable logistic regression was employed to identify factors significantly associated with fertility desire.The study found that 52.1% of participants expressed a desire for children (95% CI: 47.9, 57.6).Key factors influencing fertility desire specifically, widowed individuals had lower odds of desiring children aged 18-29 (AOR: 2.3, 95% CI: 1.1-4.8), aged 30-40 (AOR: 2.1, 95% CI: 1.3-3.3), individuals with one or fewer children (AOR: 2.4, 95% CI: 1.2-4.6), and those with 2-3 children had an AOR of 1.9 (95% CI: 1, 3.5) higher odds of desire children. A lack of awareness regarding MTCT was linked to an AOR of 2.1 (95% CI: 1, 4.4) for expressing a desire for children. Conclusion: The findings demonstrate a relatively high proportion of fertility desire among HIV-positive adult men and women on ART in Northeast Ethiopia from the national prevalence. This finding underscores efforts should be directed for individuals aged 18 to 29 along with those aged 30 to 40, and with one or fewer children and those with two to three children to enhance fertility desire. It's also important to address the needs of widowed individuals, who have lower odds of desiring children. The awareness-raising initiatives concerning the prevention of mother-to-child transmission among PLHIV by healthcare providers, highlighting the importance of informed reproductive health choices for PLHIV.