Influences in fertility decisions among HIV-infected individuals in Lilongwe, Malawi: a qualitative study

J Fam Plann Reprod Health Care. 2017 Jul;43(3):210-215. doi: 10.1136/jfprhc-2015-101395. Epub 2016 Jun 16.

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.

Keywords: Family planning; HIV; Malawi; fertility.