Fertility and health among discordant couples living with HIV

This paper examines the relationship between HIV/AIDS and fertility growth in North Centre zone (NCz) of Nigeria. The NCZ has the highest HIV/AIDS prevalence cases from the six Geo-political zones in Nigeria. The focus states in NCZ include: Benue, Niger, Nasarawa and the Federal Capital Territory (FCT). These four states have the highest HIV/AIDS prevalence rate in NCZ as revealed by National Bureau of Statistics (2009).The demographic transition theory by Thompson .W. (1929) and Traits-Desires-Intentions-Behavior (TDIB) framework developed by Miller (1994) were adopted as the theoretical framework and the empirical analysis was carried out using primary data of 200 women that are seropositive and 200 women that are not. The preliminary result shows that some seropositive women tend to have more children as a result of antiretroviral drugs and new developed drugs that reduce the risks of mother to child transmission. Also, other seropositive women tend to reduce the numbers of Children they desire to have as a result of high cost of health care and fear of short life expectancy. For the non- infected women, the result shows that fertility rate is declining. Currently, the relationship between HIV/AIDS and fertility growth is inconclusive in Nigeria.

Fertility intentions are strong predictors of eventual fertility, yet little is known about the fertility desires of HIV-infected persons in sub-Saharan Africa. Given the recent and rapid expansion of access to antiretroviral therapy (ART), understanding the fertility intentions, and consequent reproductive health services needs, of men and women living with HIV/AIDS is critical. Emerging evidence on the effect of HIV/AIDS/ART on fertility intentions is mixed with little or no explicit theoretical understanding. This study investigates fertility intentions of PLWHA using mixed methods population-based data collected 2010-11, comprising survey (n=513) and in-depth (n=41) qualitative interviews of PLWHA in Nairobi slums. We show that fertility intentions of PLWHA are fraught with ambivalence and ambiguity due to conflicts between social pressures for biological parenthood and moral pressures to avoid co-infection and future child orphanhood. The implications for reproductive health service provision are explored using in-depth interviews (n=14) with service providers.