Reproductive health needs among people living with HIV/AIDS in coast region, Tanzania.

Abstract

Background: Scaling up of antiretroviral therapy (ART) is currently underway in sub-Saharan Africa including, Tanzania, increasing survival of people living with HIV/AIDS (PLWHA) and the majority of this population is of the reproductive age. This may call for programmes to pay attention to PLWHA‟s reproductive health needs. Information on fertility desire and intention would assist in the integration of sexual and reproductive health in routine care and treatment clinics in both Urban and rural areas. Despite the fact that majority of people living with HIV are of reproductive age, little attention is given to their reproductive health needs. The purpose of this study was to determine the prevalence of fertility desires and intentions among PLWHA. Methodology A cross-sectional study was conducted in rural and urban settings of the Coast/Pwani region districts in May 2014 at selected districts Care and Treatment Clinics (CTCs) namely Tumbi Referral hospital and Mkuranga district hospital. A total of 368 eligible PLWHA (aged 15-54years) consented and participated. Face-to-face interview were conducted using a standard questionnaire. The data obtained from this study was processed and analyzed using SPSS version 20.0. Results The prevalence of fertility desire was 107(35%) and the fertility intention was 3 the majority desiring 0-3 as their total number of children to have in their life time. Fertility desire was predicted marital status where by being single (Adjusted Odds Ratio (AOR): 13.86, 95%CI: 4.14-46.38) and those who were married AOR: 2.23, 95%CI: 2.49-10.13, Urban residence AOR:2.34, 95%:CI 2.28-4.46 Fertility desire was associated with CD4 level >200 AOR:1.08, 95% CI:2.32-3.72, having child with current partiner AOR:0.016, 95%CI:0.004-0.006, Partiner want children AOR:0.70, 95%CI 0.02-0.27 Fertlity inetention was predicted by age where by those belonged to age group 25-34 AOR:6.91,95%CI 2.58-30.28 and marital status where by being single AOR:0.74, 95%CI:0.10-0.57,and cohabiting AOR:0.66, 95%CI:0.01-0.65. Fertility intention was associated with education where by those with secondary education level AOR: 0.09, 95% CI: 0.01-0.63, those who perceived their health status as good AOR: 7.38, 95% CI: 2.12-48.53. About 65.9% of participants reported using FP. Use of FP was associated with being married (AOR, 0.36, 95%CI: 0.03-0.95), ART use AOR: 8.49, 95%CI: 2.36-52.98, urban residence was associated with FP use but Adjusted Odds Ratios (AOR) was computed statistical siginificant was not achieved.These findings indicate that a substantial number of PLWHA want to have children. ART is not related to fertility desire and intention but has an influence on use of FP. Conclusion Fertility desire and intention of PLWHA was substantially high though lower than that of the general population in Tanzania. Having a child with the current partner and the importance of partiner wanting a child has association with the fertility desire and intentions. A number of pregnancies that were reported after HIV diagnosis of the respondents mean that the PLWHA desire and intend to have children. The current family planning prevalence and the need for fewer children indicate a higher demand for FP. There is therefore a need to promote and intergrate reproductive and child health into care and treatment (CT) services especially in rural areas.