Women's desire for children in an HIV population: a clinical pilot study in Burkina Faso

Today, thanks to the HAART, HIV has become a chronic disease. In most cases, HIV positive women are of reproductive age and at present, the vertical transmission rate is around 0.1% for women with an undetectable viral load. So, it is normal that the question of seropositive women's desire to have children is on the table.

In this experimental study, 50 HIV-seropositive and 44 seronegative women were interviewed about their desire to have children. Some of the questions asked were: "How many children did you want to have before you got married/at 15 years of age if you aren't married?" "How many children would you like to have today, considering your present situation?". In case of a difference between "before" and "now", we asked them: "What are the reasons for this difference?". This study was performed in Burkina Faso.

The positive women tend to desire more children "before" and fewer children "now" than negative women (OR: 1.33; C.I. 95%: 0.86-2; p= 0.19 vs OR: 0.78; C.I. 95%: 0.51-1.21; p= 0.27). 62% of HIV positive women mention multiple reasons directly linked to their seropositivity to explain the difference between "before" and "now". 70% of HIV positive women still want to have children. We have noted that the positive women who still want children are more likely to be younger (p < 0.05 by Two-Sample T tests), in a relationship (p < 0.01 by Chi-Square Test) and to have been diagnosed earlier than the positive women who don't want any children (p=0.01 by Wilcoxon Rank Sum Test).

Even if the results of this pilot study are preliminary, they show that HIV positive and negative women have a relatively similar desire for children, even though seropositive women seem to want fewer children than their uninfected counterparts. Most of the reasons which reduce HIV positive women's desire to have children are directly linked to HIV. This is why getting these women informed about materno-fetal transmission risks and existing treatments is really important to give them the opportunity to make a conscious choice.