Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

Background: In a setting with high HIV prevalence and high fertility rates, addressing fertility issues of People Living with HIV/AIDS (PLWHA) is crucial. However, understanding of the factors associated with fertility decisions of PLWHA in Ethiopia is remarkably low. Objective: The study was conducted to assess factors associated with fertility decisions of PLWHA in South Wollo Zone, Northeast Ethiopia. Methods: The study was conducted from February 1 to March 30, 2008 using cross-sectional design. Quantitative data were collected from a sample of 458 men and 458 women using structured questionnaire. Qualitative data were also collected from six health care providers. Logistic regression was used to analyze the quantitative data. Results: The study showed that 18.3% of currently married PLWHA have decided to have a child. The factors found to be independently associated with current decision to have a child were higher family income [OR (95% CI) = 2.29 (1.23, 4.26)], partner’s decision to have a child [OR (95% CI) = 36.4 (17.0, 77.5)], having knowledge on PMTCT [OR (95% CI) = 2.26 (1.44, 3.54)] and having partner with negative HIV test result [OR (95% CI) = 0.408 (0.219, 0.759)]. During in-depth interview the health care providers indicated the fertility related counseling service to be low. Conclusion: In spite of the fact that significant proportion of married PLWHA had decided to have a child, the fertility related counseling service is low. Improving fertility related counseling services to enable clients make informed fertility decision is mandatory. The factors identified to be associated with fertility decision could be of major importance and as such should be investigated further.