Reproductive Desires and Intentions among HIV-infected Individuals in Chennai, India

by Houle, Elizabeth

Despite the personal and cultural importance of childbearing in India, limited information exists on the extent of childbearing desires and intentions among HIV-infected individuals in this setting. The purpose of this study was to measure the extent of childbearing desires among HIV-infected individuals in Chennai, India, thereby testing the hypothesis that HIV significantly influences the desire to have children. Three hundred HIV-infected individuals were interviewed about childbearing desires and intentions during routine visits for HIV care at an HIV specialty care clinic in Chennai, South India. Sixteen percent of participants expressed desire for childbearing, and 9% expressed intention to have children in the future. Desire for children was associated with childlessness (OR 7.38, 95% CI 3.18-17.15), longer time since diagnosis with HIV (OR 2.187, 95% CI 1.511-5.511), and absence of financial concerns about bearing children (OR 3.81, 95% CI 1.77-8.21). Childbearing desires decreased with increasing age (OR 0.922, 95% CI 0.87-0.98). Childbearing desires were not associated with measures of disease progression. The most frequently cited concerns about childbearing among participants were the potential of infecting the infant (71%) followed by the burden of the participants own illness (49%). Thirty-five percent of participants reported lack of knowledge about reducing transmission of HIV for couples trying to conceive. Although 84% of the cohort expressed no desire for childbearing, nearly half (48%) of those without desire stated that in the absence of HIV infection they would desire and or intend to have children. When compared with individuals who desired children regardless of HIV infection, these individuals were more inclined to have at least one child already, resided in the state of Andhra Pradesh, had known their diagnosis for a shorter time, and had more childbearing concerns related to HIV infection. Although the prevalence of childbearing desire and intent are lower among this population than in HIV-infected populations studied in other settings, it is likely that childbearing among HIV-infected individuals in India will become increasingly important as HIV-infected patients live longer and healthier lives through increasing access Highly Active Antiretroviral Therapy (HAART) in India.