Fertility Desire and Its Associated Factors Among People Living with HIV Attending Antiretroviral Therapy in Addis Ababa, Ethiopia

Background: Worldwide, due to the increased in the accessibility of antiretroviral therapy the number of people living with HIV (PLHIV) is increasing. The treatment has improved the health status and life expectancy of PLHIV making them to enjoy life similar to uninfected individuals. Even though efforts are being made directed towards expanding the service globally and in sub-Saharan Africa, but little attention is given towards the reproductive health needs of PLHIV. Now a day’s people living HIV continued to desire a child requiring a global attention. Therefore, this study was aimed to assess fertility desire and the associated factors among people living with HIV in Addis Ababa, Ethiopia, 2023/24. Method: A health facility based cross-sectional study was conducted among 602 people living with HIV in Addis Ababa, Ethiopia. A multi-stage sampling technique was used to select the study participants. Using SPSS version 27 binary and multivariable logistic regression was done to ascertain the factors associated with fertility desire with a 95% confidence interval. Results: In the past six months 83.1% of the PLHIV were sexually active. Overall, nearly half (47.25%) of the PLHIV had reported fertility desire. People living with HIV who had no child had a higher odds of fertility desire (AOR (95% C.I): 2.70 (1.71- 4.24)) than who had children. In addition to this, being single, partner fertility desire, discussion with an ART provider about sexuality, fertility desire and family planning, had faced community pressure to have a child, perceived improved health status, had an HIV negative sexual partner and HIV diagnosed before nine years were found to be predictors of fertility intentions. Conclusion: Nearly half of the PLHIV had reported fertility desire in the future where discussion about sexuality, fertility desire and family planning with ART provider had showna significant association with it. Therefore, health care providers and the concerned bodies should work together in strengthening the reproductive health needs of PLHIV along with HIV care and support so that they may decide freely and responsibly on their own reproductive health matters.