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Fertility intentions of prenatal and postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: a longitudinal study

Authors Peltzer K, Sifunda S, Mandell LN, Rodriguez VJ, Lee TK, Cook R, Weiss SM, Jones DL

Received 4 October 2017

Accepted for publication 28 December 2017

Published 16 February 2018 Volume 2018:10 Pages 9—17

DOI https://doi.org/10.2147/HIV.S153212

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya


Karl Peltzer,1,2 Sibusiso Sifunda,1 Lissa N Mandell,3 Violeta J Rodriguez,3 Tae Kyoung Lee,4 Ryan Cook,5 Stephen M Weiss,3 Deborah L Jones3

1
HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa; 2Department of Research and Innovation, University of Limpopo, Sovenga, South Africa; 3Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 4Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 5School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA

Introduction: This study aimed to assess fertility intentions (planning to have more children in the future) and associated factors among pregnant and postpartum HIV positive women in rural South Africa.
Methods: In a longitudinal study, as part of a prevention of mother to child transmission (PMTCT) intervention trial, 699 HIV positive prenatal women, were systematically recruited and followed up at 6 months and 12 months postpartum (retention rate = 59.5%).
Results: At baseline, 32.9% of the women indicated fertility intentions and at 12 months postnatal, 120 (28.0%) reported fertility intentions. In longitudinal analyses, which included time-invariant baseline characteristics predicting fertility intention over time, not having children, having a partner with unknown/HIV-negative status, and having disclosed their HIV status to their partner, were associated with fertility intentions. In a model with time-varying covariates, decreased family planning knowledge, talking to a provider about a future pregnancy, and increased male involvement were associated with fertility intentions.
Conclusion: Results support ongoing perinatal family planning and PMTCT education.

Keywords: fertility intentions, family planning, HIV infection, pregnancy, South Africa, male involvement

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