Fertility intentions and family planning demand among HIV positive men and women in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria
This study assessed the fertility intentions among HIV positive men and women, assessed their demand for contraception. The study also ascertainedfactors that influenced their fertility intentions and contraceptive demand, compare patterns of contraception and fertility intentions between male and female HIV clients attending the Institute of Human Virology of Obafemi Awolowo University Teaching Hospitals Complex with a view of providing information that will help in proposing strategies tailored towards counselling and service needs of the clients. The study was a cross-sectional survey carried out among 300 HIV positive men and women accessing care in the institute. The study employed quantitative and qualitative survey design. The data collection took place over 20 clinic days and 15 respondents were recruited on each clinic day (300/20=15).A sampling interval (k) of 5 was determined as an average of 80 clients were being attended to on each clinic day (80/15=5). The first enrolee on each day of data collection was selected by simple random sampling from the first 5 clients, every 5th patient after that was enrolled into the study until 15 respondents had been selected. For the qualitative survey,key informant interview was conducted with a senior resident doctor rotating from obstetrics and gynaecology, a senior resident doctor from venereal and dermatology, the matron in charge of clinical care and counselling services and a nurse. Univariate, bivariate and multivariate analyses were done and degree of statistical significance was accepted at p-value less than 0.05. The qualitative data was analysed using content analysis. One hundred and eighty-one (60.3%) comprising 32(56.1%) male and 149 (61.3%) female respondents expressed desire for children. The respondents aged 20-29 years [OR = 10.74, 95% CI: 2.76 – 41.70] and 30-39 years [OR = 2.76, 95% CI: 1.51 -5.03] were ten times and three times more likely to desire children when compared to those aged 40years and above. Respondents who had no children [OR= 41.36, 95% CI: 4.75-360.18] were forty-one times more likely to desire children compared to those who had 1 or more children. One hundred and eighty-four (61.3%) of the respondents were using family planning methods during the study period and 38.7%were not using family planning methods.Sixty-six percent of non-users expressed desire to use family planning methods in future.Respondents with 3 or more living children [OR=0.14, 95% CI: 0.04-0.54] were 0.14 times less likely to desire to use family planning methods when compared to those who had none. Current family planning users [OR=5.48, CI: 2.86-10.52] were 5 times more likely to express desire to continue using family planning in future compared to non-current users. The study showed that the factors that influenced fertility intentions were age and number of living children. The factors that influenced contraceptive demand were number of living children and current use of family planning. Family planning services should be integrated into HIV treatment and care so as to promote a “one-stop shopping” for both HIV/AIDS care and Reproductive health services for PLWHA.