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Understanding the Socio-Psychological, Demographic, Obstetric and Treatment-Status Aspects of Fertility Desire among Anti-Retroviral Treatment Clients, Dodota District, Oromia, Ethiopia

Yohannes Kebede, Guta Tola and Ashenafi Habtamu

Background: The reproductive decisions made by partners of and people living with HIV/AIDS (PLWHA) impact the wellbeing of their families. Multi contexts correlates of fertility desire are less studied among Anti-Retroviral Therapy (ARVT) clients.

Methods: We used health facility based cross sectional study design. The study was conducted from February 20 to March 30, 2016 on 242 ARVT clients. A pre-tested and structured questionnaire was used to collect quantitative data. The data were analyzed using the windows statistical package for social science software version 21. Univariate, bivariate and multivariate analysis were used to describe fertility desires and associated factors.

Results: Ninety-five (39.3%) of the ARVT clients wished to have more children. One hundred thirty two (54.5%) of them were using Family Planning (FP) methods. Two-third of, or 91 (68.9%) FP users planned to have no more children. Seventy-six (31.6%) of the respondents gave birth after knowing their HIV sero-status. Young males who had never had child and married respondents were more likely to desire fertility in the foreseable future compared to their counterparts. Respondents, who work as merchants were less likely to wish to have a child compared to the housewives. Two hundred thirty-nine (97.6%) of the respondents generally knew about Prevention of Mother to Child Transmission (PMTCT) of HV/AIDS. This level of knowledge was strongly associated with fertility desire itself. In fact, qualitative findings portrayed social pressure, perceived compensation from giving birth to a healthy newborn and eagerness for confirmation as chief reasons for the desire to give birth to a baby. Knowledge of PMTCT of HIV/AIDS moderated the paths of these chief reasons. Having been followed for a long time in an ARVT clinic and better recent CD4 counts were significant contributors to fertility desire.

Conclusions: Two in every five ARVT clients wish to have a child. To meet their fertility desires; socio-demographic, maternity and psychosocial contexts specific Information-Education-Communication (IEC) should be initiated shortly after enrollment on ARVT. Those who never gave birth, males, married, merchants deserve especial attention.