Factors associated with fertility desires and intentions among HIV positive women enrolled at a HIV treatment clinic in Windhoek, Namibia

Chakare, Tafadzwa (2013-03)

Thesis (MPhil)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: Fertility patterns among Persons living with HIV (PLHIV) could have important HIV prevention and demographic implications particularly in high prevalence settings. Fertility volitions and associated factors among PLHIV have been documented in many countries, but there is a paucity of data on Namibia. Knowledge on health worker attitudes towards positive parenting is also lacking. Using a cross-sectional survey design, data was collected from 50 HIV positive women of reproductive age using an interviewer administered questionnaire. Social, demographic, sexual, reproductive and other variables were explored. In addition, a self-administered questionnaire was presented to 15 health workers at the target site to assess the service provider environment vis-à-vis positive parenting. The mean age of the HIV positive women was 34.2 years and 71.4% were sexually active. Most (80%) were in relationships but only 10% were married. Approximately 22.2% did not know their partner’s HIV status and 17% had not disclosed their HIV status to their partner. Childbearing after HIV diagnosis was common and fertility desires (44.9%) and intentions (42%) were abundant. The service provider environment was generally PLHIV friendly but discouraged childbearing especially among women who were already parents. Descriptive analysis showed possible connections between elevated fertility desires and/or intentions and higher education levels, having a partner, not having children, not having children in the current relationship, history of HIV related child death, less formal relationships, shorter relationships, disclosure to partner, awareness of partner’s status, having a HIV negative partner, STI treatment after HIV diagnosis, Prevention of Mother-to-Child Transmission experience as well as anti-retroviral therapy status. Of the relationships subjected to inferential analysis, none was statistically significant. Many were not testable due to limitations emanating from the small sample size.

AFRIKAANSE OPSOMMING: Fertiliteitspatrone onder mense wat met MIV saamleef (PLHIV), kan belangrike MIV-voorkomings en demografiese implikasies inhou, veral in hoë voorkomsgebiede. Fertiliteitsvoorkeure en geassosieerde faktore onder PLHIV is in vele lande te boek gestel, maar daar bestaan ‘n gebrek aan data wat Namibië betref. Kennis oor gesondheidswerkers se ingesteldhede teenoor positiewe ouerskap is ook gebrekkig. Data is uit die geledere van 50 MIV-positiewe vroue van voortplantingsouderdom verkry deur onderhoudvoering en vraelys, asook deur gebruikmaking van ‘n oorkruis-deursnee opname-ontwerp en sosiale, demografiese, seksuele, voorplantings en ander veranderlikes is ondersoek. Daarbenewens is ‘n selfgeadministreerde vraelys aan 15 gesondheidswerkers op die teiken-terrein voorgelê om die diensvoorsienersomgewing ten opsigte van positiewe ouerskap te probeer assesseer. Die verteenwoordigende ouderdom van die positiewe vroue was 34.2 jaar en 71.4% van hulle was seksueel aktief. Die meerderheid (80%) was in verhoudings, maar net 10% was getroud. Sowat 22% het nie geweet wat hulle maats se MIV-status was nie en 17% het nie hulle MIV-status aan hul maats verstrek nie. Kindergeboorte na MIV-diagnose het algemeen voorgekom en voortplantingswense (44.9%) en –intensies (42%) was volop. Die diensvoorsieningsomgewing was oor die algemeen PLHIV-vriendelik, maar swangerskappe, veral onder vroue wat reeds ouers was, is ontmoedig. Omskrywende analise het gedui op moontlike verbintenisse tussen hoë fertiliteitswense en/of –intensies en hoër onderwysvlakke, die teenwoordigheid van ‘n maat, nie kinders te hê nie, nie kinders in die huidige verhouding te hê nie, geskiedenis van MIV-verwante kindersterftes, minder formele verhoudings, korter verhoudings, openbaarmaking aan maat, bewustheid van maat se status, in verhouding wees met ‘n MIV-negatiewe maat, behandeling vir seksueel oordragbare infeksie na diagnose van MIV, Voorkoming van Moeder-tot-Kind oordragsondervinding sowel as anti-retrovirale terapiestatus. Nie een van die verhoudings wat wat aan afleibare analise onderwerp is, was statistiekgesproke beduidend nie. Talle verhoudings kon weens beperkinge voortspruitend uit die klein monstergrootte nie getoets word nie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/80263
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