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Fertility desires among men and women living with HIV/AIDS in Nairobi slums: a mixed methods study

Wekesa, Eliud and Coast, Ernestina ORCID: 0000-0002-8703-307X (2014) Fertility desires among men and women living with HIV/AIDS in Nairobi slums: a mixed methods study. PLOS ONE, 9 (8). e106292. ISSN 1932-6203

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Identification Number: 10.1371/journal.pone.0106292


Objectives: Fertility desires require new understanding in a context of expanding access to antiretroviral therapy for people living with HIV/AIDS in Sub-Saharan Africa. This paper studies the fertility desires and their rationales, of slum-dwelling Kenyan men and women living with HIV/AIDS who know their serostatus, but have different antiretroviral therapy treatment statuses. It addresses two research questions: How do people living with HIV/AIDS consider their future fertility? What factors contribute to an explanation of fertility desires among people living with HIV/AIDS. Methods: A mixed methods study (survey [n = 513] and in-depth interviews [n = 41]) with adults living with HIV/AIDS living in Nairobi slums was conducted in 2010. Regression analyses assess independent relationships between fertility desires and socio-demographic factors. Analyses of in-depth interviews are used to interpret the statistical analyses of fertility desires. Results: Our analyses show that fertility desires are complex and ambivalent, reflecting tensions between familial and societal pressures to have children versus pressures for HIV (re-)infection prevention. More than a third (34%) of men and women living with HIV expressed future fertility desires; however, this is significantly lower than in the general population. Factors independently associated with desiring a child among people living with HIV/AIDS were age, sex, number of surviving children, social support and household wealth of the respondent. Discussion: Increasing access to ART is changing the context of future childbearing for people living with HIV/AIDS. Prevailing values mean that, for many people living with HIV/AIDS, having children is seen as necessary for a ‘‘normal’’ and healthy adult life. However, the social rewards of childbearing conflict with moral imperatives of HIV prevention, presenting dilemmas about the ‘‘proper’’ reproductive behaviour of people living with HIV/AIDS. The health policy and service delivery implications of these findings are explored.

Item Type: Article
Official URL:
Additional Information: © 2014 The Authors
Divisions: Social Policy
LSE Health
Subjects: H Social Sciences > HQ The family. Marriage. Woman
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 05 Sep 2014 13:06
Last Modified: 20 Sep 2021 02:04
Funders: Wellcome Trust [078471/Z/05/A], Fred H. Bixby Fellowship

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