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Influences in fertility decisions among HIV-infected individuals in Lilongwe, Malawi: a qualitative study
  1. Lisa B Haddad1,
  2. Alexandra B Hoagland2,
  3. Karen L Andes3,
  4. Bernadette Samala4,
  5. Caryl Feldacker5,
  6. Kingsley Chikaphupha6,
  7. Hannock Tweya7,
  8. Jane Chiwoko8,
  9. Fannie Kachale9,
  10. Denise J Jamieson10,
  11. Sam Phiri11
  1. 1Assistant Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
  2. 2Graduate Student, Hubert Department of Global Health, Emory University, Atlanta, GA, USA
  3. 3Assistant Professor, Hubert Department of Global Health, Emory University, Atlanta, GA, USA
  4. 4Data Clerk, The Lighthouse Trust, Lilongwe, Malawi
  5. 5Research and Evaluation Advisor, International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
  6. 6Research Officer, Research for Equity and Community Health Trust (REACH) Trust, Lilongwe, Malawi
  7. 7Monitoring, Evaluation and Research Director, The Lighthouse Trust, Lilongwe, Malawi
  8. 8Clinical nurse, The Lighthouse Trust, Lilongwe, Malawi
  9. 9Deputy Director, Reproductive Health Services, Ministry of Health, Lilongwe, Malawi
  10. 10Adjunct Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
  11. 11Executive Director, The Lighthouse Trust, Lilongwe, Malawi
  1. Correspondence to Dr Lisa B Haddad, Department of Gynecology and Obstetrics, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303, USA; lbhadda{at}emory.edu

Abstract

Background The motivation to have a child may be complex with numerous influencing factors, particularly among individuals living with HIV. This study sought to understand factors influencing fertility decision-making for HIV-infected men and women in Lilongwe, Malawi.

Methods Thirteen focus groups were conducted among HIV-infected individuals enrolled in antiretroviral treatment services.

Results Participants identified a hierarchy of influences in fertility decisions including the importance of childbearing, patriarchal influence, family influences and concern regarding HIV transmission.

Conclusions Addressing fertility conversations beyond the confines of a relationship may be important, as family plays a significant role in fertility choices. Childbearing remains a fundamental desire among many individuals with HIV; however, concerns regarding transmission risk need to be addressed with efforts made to overcome misconception and assist individuals in balancing what may be competing influences.

  • fertility
  • HIV
  • Family planning
  • Malawi

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