Fertility Desire Among HIV-Positive Men and Women Receiving Care at a Large Tertiary Referral Hospital in Ethiopia

ABSTRACT Background: An estimated 75% of people living with HIV (PLHIV) globally are within the reproductive age group. In Sub-Saharan Africa, fertility desire remains high despite HIV diagnosis, raising concerns for vertical transmission. Understanding fertility intentions is crucial for developing targeted reproductive health interventions in HIV care. Hence, the aim of this study was to assess the prevalence of fertility desire and associated factors among HIV-positive men and women receiving follow-up care at St. Paul's Hospital Millennium Medical College (SPHMMC) ART units in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from May to June 2017, involving 260 PLHIV aged 18-54 years. Structured questionnaires were used for data collection. Descriptive statistics were used to summarize participant characteristics. Multivariable binary logistic regression analysis was performed at 5% level of significance to identify significant factors associated with fertility desire. Results: Of the 260 participants, 133 (51.2%) expressed a desire to have children. Fertility desire was reported by 54.7% of women and 46.4% of men. Significant factors associated with fertility desire were younger age (18–29 years), not having a child, and having a partner with a fertility desire. On the other hand, having low monthly income was associated with no fertility desire. Conclusions: A substantial proportion of HIV-positive individuals receiving ART expressed fertility desire. Young age, not having a child, low income, and partner’s fertility desire were key influencing factors. Integrating comprehensive reproductive health counseling, including partner-inclusive decision-making, into HIV care services and enhancing Prevention of Mother-to-Child Transmission (PMTCT) services for clients expressing fertility desire is essential. Key words: Fertility desire, HIV-positive individuals, Prevention of Mother-to-Child Transmission (PMTCT), cross-sectional study, Ethiopia