Fertility desire and associated factors among reproductive age women attending antiretroviral therapy at public hospitals in Eastern Ethiopia.

Background: Human immune virus (HIV) remains a major cause of death in children and women worldwide. Women's desire to have children in the future has significant implications for the transmission of the human immune deficiency virus to sexual partners and newborns. People living with HIV desire to have children, and counseling by their healthcare providers plays a critical role in ensuring planned pregnancies and minimizing mother-to-child transmission. However, in many settings, a large majority of HIV-positive women who desire more children do not discuss reproductive health and childbearing with their healthcare providers. The objective of this study was to assess fertility desire and associated factors among reproductive age women living with a HIV attending antiretroviral therapy (ART) in public hospitals in Eastern Ethiopia.

Design: Cross-sectional study.

Methods: A facility-based cross-sectional study was conducted on November 01-30, 2022 among 598 reproductive age women attending ART clinics in public hospitals in Eastern Ethiopia. A systematic random sampling technique was used to select the participants. Data were collected from five female nurses through face-to-face interviews using a structured and pre-tested questionnaire. Data were entered into Epi-Data 3.1 and analyzed using IBM SPSS version 24. Bivariate and multivariable logistic regression analyses were performed. Variables with a p-value <0.25 in bivariate analysis were included in the multivariable logistic regression analysis. Variables associated with desire for fertility were declared at p-value <0.05, with adjusted odds ratio (AOR) and 95% confidence intervals (95% CI).

Results: This study showed that 42.0% (95% CI: 31.7%-52.28%) of women had a desire for fertility. Women aged (15-24) (AOR = 2.52, 95% CI: 1.58-3.50), married women (AOR = 3.21, 95% CI 1.42-5.11), having no children (AOR = 1.94, 95% CI: 1.51-2.52), and desire to have children (AOR = 2.98, 95% CI: 1.84-4.12) were significantly associated with desire for fertility.

Conclusion: This study revealed that a significant proportion of women desire fertility despite their positive status. Moreover, being young, married, having no child, and having a partner's desire to have children were factors associated with the desire for fertility.