Factors Associated with Intention to Conceive and its Communication to Providers Among HIV Clients in Uganda

Persons living with HIV/AIDS (PLHA) must discuss their fertility intentions with healthcare providers to receive the support
needed to have children safely and limit transmission risks. However, few quantitative studies have examined correlates of
fertility intentions, let alone the communication of such intentions with providers. We examined the prevalence and correlates
of intentions to have children, and comfort discussing such plans with one’s providers, in HIV clients at two HIV clinics
in Uganda. Cross-sectional self-report data were collected from 233 patients who had primary partners. Bivariate correlates
significant at the P < 0.10 level were included in logistic regression analysis. Of the 233 participants, 103 (44%) reported an intention to conceive
a child in the near future. In multivariate analysis, younger age of both the patient and their partner, better physical health
functioning and higher internalized HIV stigma were associated with having fertility intentions. One-third (35%) of those
with fertility intentions expressed having difficulty discussing these intentions with their providers, which was associated
with receiving care at the rural clinic and greater internalized HIV stigma. These findings highlight the need for reproductive
health services that help clients accept themselves as PLHA and their fertility rights, thus promoting patient-doctor communication
needed to promote safe child conception and delivery outcomes.