"If I don't have children, they will know that I'm sick": fertility desires of women and men living with HIV in Iringa, Tanzania

• Published in: AIDS care Vol. 31; no. 7; pp. 908 - 911
• Main Authors: Saleem, Haneefa T., Surkan, Pamela J., Kerrigan, Deanna, Kennedy, Caitlin E.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.07.2019; Taylor & Francis Ltd
• Subjects: Adult; AIDS/HIV; Anti-HIV Agents - therapeutic use; Antiretroviral drugs; Child; Children; Counseling; Disease control; Disease transmission; Family Characteristics; Family size; Female; Fertility; fertility desires; Fertilization; Health care; Health care industry; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; Health risks; Health services; HIV; HIV Infections - drug therapy; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infant mortality; Infants; Infectious Disease Transmission, Vertical - prevention & control; Interviews as Topic; Male; Maternal and infant welfare; Medicine; Men; Middle Aged; Motivation; Pregnancy; Qualitative Research; safer conception; Sexual Partners - psychology; Social Stigma; Stigma; Tanzania; Women; Young Adult; Tanzania; safer conception; fertility desires; qualitative research; HIV; Tanzania
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2019.1576844

As safer conception services are expanded and integrated into HIV care systems, these services will need to address cultural, social, economic and medical concerns of women and men living with HIV. We conducted interviews with 30 HIV-positive women, 30 HIV-positive men, and 30 healthcare providers that examined factors specific to the experience of living with HIV that influence fertility desires in Iringa, Tanzania. HIV-related factors fell under five themes: knowing one could prevent mother-to-child transmission; reaching an ideal family size in the context of HIV-related infant mortality; concealing one's HIV status; being able to provide for children; and managing HIV disease progression. Integration of safer conception counseling that includes locally-tailored messaging around desired family size, health risks, stigma and financial considerations into safer conception services will help people living with HIV reach their reproductive goals, while reducing the risks of HIV transmission.