Child desire in women and men living with HIV attending HIV outpatient clinics: evidence from a European multicentre study.

Objectives: Fertility-related decisions are challenging for women and couples living with HIV, in spite of vertical HIV transmission rates lower than 1% under effective antiretroviral treatment. This multicentre study identified factors influencing child desire of women and men living with HIV in Europe.

Methods: We gathered quantitative data by means of anonymous, self-administered questionnaires distributed through a network of 13 European HIV treatment centres. Data analysis employed descriptive statistics and multivariate logistic regression.

Results: The majority of 427 heterosexual HIV-positive study participants were sexually active. Forty-three percent reported a child desire, 28% had unmet family planning needs. Factors independently associated with child desire were: being younger than 36 years for both genders, and having no children for women. Perceived HIV-related discrimination by health care providers was associated negatively with child desire for women, but positively for men.

Conclusions: Many women and men living with HIV in Europe desire children and have fertility intentions, for which they need unbiased support to conceive and deliver safely. Comprehensive and gender-specific sexual and reproductive health counselling, including pre-conception and contraceptive counselling, should be integrated into HIV care delivery.