Determinants of fertility preferences among HIV infected mothers in Uasin Gichu District, Kenya
Occurrence of the HIV and AIDS pandemic among childbearing women has necessitated these women to reconsider their future fertility preferences. Generally women who learn that they are HIV infected may have a strong desire to avoid bearing additional children who may be born HIV infected and/or will become orphaned at an early age. Availability of safe and effective contraception and high quality reproductive health counseling can help a woman practice safer sex and determine her future childbearing on a more responsible and informed basis. A descriptive cross-sectional study was undertaken in Uasin Gishu District of Rift Valley Province. A total of 400 consenting HIV infected mothers were interviewed using a pre-tested interview schedule. To validate the respondents' feedback and ascertain the perception of the Health Care Providers towards fertility among HIV infected mothers a questionnaire was administered on them. Data were analyzed using SPSS statistical package version 11.5. The highest proportion of desire to get additional children (53.5%) was seen amongst those respondents aged 15-19 years while the lowest desire for additional children was recorded amongst age group 40-44 years with none (0.0%) desiring to get additional children. There was a significant statistical relationship between age and fertility preferences (x2=21.699; df=5; P=0.001). Majority (77.5%) of respondents had two or more children. Majority (85.1%) of the respondents who knew about all the three stages of MTCT; pregnancy, delivery and breastfeeding did not intend to get additional children while onethird (33.3%) of those who did not know any stage of MTCT still intended to get additional children. There was a significant relationship between knowledge on MTCT and fertility preference among the respondents (x2 =20.213; df=7; P=0.005). The study reveals that none of the respondents who had knowledge on at least six contraceptive methods wished to get additional children whereas all of those who knew only one method did desire to get additional children. A significant relationship was found between the number of methods familiar to the respondents and their fertility preference (x2 =12.307; df=5; P=0.031). The findings of this study will be used addressing gaps in reproductive health services and counseling among HIV infected women. Though most of the HCP (health care providers) had an additional job-relevant training, they were inadequate in basic training and hence its implementation. It is recommended that more heath care providers be trained specifically on family planning and PMTCT of HIV.