Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

My partner wants a child: A cross-sectional study of the determinants of the desire for children among mutually disclosed sero-discordant couples receiving care in Uganda

Jolly Beyeza-Kashesya12*, Anna Mia Ekstrom2, Frank Kaharuza1, Florence Mirembe1, Stella Neema3 and Asli Kulane2

  • * Corresponding author: Jolly Beyeza-Kashesya jbeyeza@yahoo.com

  • † Equal contributors

Author Affiliations

1 Department of Obstetrics/Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda

2 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

3 Makerere University Institute of Social Research, Kampala, Uganda

For all author emails, please log on.

BMC Public Health 2010, 10:247  doi:10.1186/1471-2458-10-247

Published: 13 May 2010

Abstract

Background

The percentages of couples in HIV sero-discordant relationships range from 5 to 31% in the various countries of Africa. Given the importance of procreation and the lack of assisted reproduction to avoid partner transmission, members of these couples are faced with a serious dilemma even after the challenge of disclosing their HIV status to their spouses. Identifying the determinants of the decision to have children among sero-discordant couples will help in setting reproductive intervention priorities in resource-poor countries.

Methods

We conducted a survey among 114 mutually disclosed sero-discordant couples (228 individuals) receiving HIV care at four centres in Greater Kampala, between June and December 2007. The data we collected was classified according to whether the man or the woman was HIV-positive. We carried out multivariate logistic regression modelling to determine factors (age, gender, and the influences of relatives and of health workers, ART knowledge, and disclosure) that are independently associated with a desire for children.

Results

The majority, 59%, of the participants, desired to have children. The belief that their partner wanted children was a major determinant of the desire to have children, irrespective of the HIV sero-status (adjusted odds ratio 24.0 (95% CI 9.15, 105.4)). Among couples in which the woman was HIV-positive, young age and relatives' expectations for children were significantly associated with increased fertility desire, while among couples in which the man was positive; knowledge of ART effectiveness was associated with increased fertility desire. Availability of information on contraception was associated with decreased fertility desire.

Conclusions

The gender of the positive partner affects the factors associated with a desire for children. Interventions targeting sero-discordant couples should explore contraceptive choices, the cultural importance of children, and partner communication.