Skip to main content Accessibility help



The increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009–2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media.

Corresponding author
1Corresponding author. Email:
Hide All
Akinyemi, J. O., Awolude, O. A., Adewole, I. F. & Kanki, P. J. (2010) Condom use among antiretroviral therapy patients in Ibadan, Nigeria. Journal of Infection in Developing Countries 4(8), 495502.
Andia, I., Kaida, A., Maier, M., Guzman, D., Emenyonu, N., Pepper, al. (2009) Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda. American Journal of Public Health 99, 340347.
Bankole, A., Biddlecom, A. & Dzekedzeke, K. (2011) Women's and men's fertility preferences and contraceptive behaviors by HIV status in 10 sub-Saharan African countries. AIDS Education and Prevention 23(4), 313328.
Biddlecom, A. E., Hessburg, L., Susheela, S., Bankole, A. & Darabi, L. (2007) Protecting the Next Generation in Sub-Saharan Africa: Learning from Adolescents to Prevent HIV and Unintended Pregnancy. Guttmacher Institute, New York.
Bonnenfant, Y. T., Hindin, M. J. & Gillespie, D. (2012) HIV diagnosis and fertility intentions among couple VCT clients in Ethiopia. AIDS Care 24(9), 10781086.
Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia & Macro International Inc. (2009) Zambia Demographic and Health Survey 2007. CSO and Macro International Inc., Calverton, MD, USA.
Cooper, D., Harries, J., Myer, L., Orner, P. & Bracken, H. (2007) “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Social Science & Medicine 65, 274283.
Elul, B., Delvaux, T., Munyana, E., Lahuerta, M., Horowitz, D., Ndagije, al. (2009) Pregnancy desires, and contraceptive knowledge and use among prevention of mother-to-child transmission clients in Rwanda. AIDS 23 (Supplement 1), S1926.
Hayford, S. R., Agadjanian, V. & Luciana, L. (2012) Now or never: perceived HIV status and fertility intentions in rural Mozambique. Studies in Family Planning 43(3), 191199.
Homsy, J., Bunnell, R., Moore, D., King, R., Malamba, S., Nakityo, al. (2009) Reproductive intentions and outcomes among women on antiretroviral therapy in rural Uganda: a prospective cohort study. PLoS ONE 4(1), e4149.
Johnson, K. B., Akwara, P., Rutstein, S. O. & Bernstein, S. (2009) Fertility preferences and the need for contraception among women living with HIV: the basis for a joint action agenda. AIDS 23 (Supplement 1), S717.
Kaida, A., Laher, F., Strathdee, S., Money, D., Janssen, P., Hogg, R. & Gray, G. (2010) Contraceptive use and method preference among women in Soweto, South Africa: the influence of expanding access to HIV care and treatment services. PLoS ONE 5(11), e13868.
Maharaj, P., Neema, S., Cleland, J., Busza, J. & Shah, I. (2012) Condom use within marriage: an assessment of changes in South Africa and Uganda. AIDS Care 24(4), 444450.
Maier, M., Andia, I., Emenyonu, N., Guzman, D., Kaida, A., Pepper, al. (2009) Antiretroviral therapy is associated with increased fertility desire, but not pregnancy or live birth, among HIV+ women in an early HIV treatment program in rural Uganda. AIDS Behaviour 13, S2837.
Makumbi, F. E., Nakigozi, G., Reynolds, S. J., Ndyanabo, A., Lutalo, al. (2011) Associations between HIV antiretroviral therapy and the prevalence and incidence of pregnancy in Rakai, Uganda. AIDS Research and Treatment doi:10.1155/2011/519492.
Mishra, V., Praween, A., Soumya, A., Yuan, G. & Wang, S. (2009) Changes in HIV-Related Knowledge and Behaviors in Sub-Saharan Africa. DHS Comparative Reports No. 24. ICF Macro, Calverton, MD, USA.
Myer, L., Carter, R. J., Katyal, M., Toro, P., El-Sadr, W. al. (2010) Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in sub-Saharan Africa: a cohort study. PLoS Med 7(2), e1000229.
Myer, L., Morroni, C. & Rebe, K. (2007) Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa. AIDS Patient Care STDs 21(4), 278285.
National Population Commission (NPC) [Nigeria] & ICF Macro (2009) Nigeria Demographic and Health Survey 2008. National Population Commission and ICF Macro, Abuja, Nigeria.
Nattabi, B., Li, J., Thompson, S. C., Orach, C. G. & Earnest, J. (2009) A systematic review of factors influencing fertility desires and intentions among people living with HIV/AIDS: implications for policy and service delivery. AIDS Behavior 13(5), 949968.
Rutenberg, N., Biddlecom, A. E. & Kaona, F. A. D. (2000) Reproductive decision-making in the context of HIV and AIDS: a qualitative study in Ndola, Zambia. International Family Planning Perspectives 26(3), 124130.
Stata Corporation (2007) Stata Statistical Software: Release 8.0. Stata Corporation, College Station, Texas.
Taulo, F., Berry, M., Tsui, A., Makanani, B., Kafula, G., Li, al. (2009) Fertility intentions of HIV-1 infected and uninfected women in Malawi: a longitudinal study. AIDS Behavior 13, S2027.
Trinitapoli, J. & Yeatman, S. (2011) Uncertainty and fertility in a generalized AIDS epidemic. American Sociological Review 76(6), 935954.
UNAIDS (2013) Global Report: UNAIDS Report on the Global AIDS Epidemic 2013. UNAIDS, Geneva.
United Nations (2002) HIV/AIDS and Fertility in Sub-Saharan Africa: A Review of the Research Literature. Department of Economic and Social Affairs, Population Division, ESA/P/WP.174. United Nations, New York.
Yeatman, S. (2009) HIV infection and fertility preferences in rural Malawi. Studies in Family Planning 40(4), 261276.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of Biosocial Science
  • ISSN: 0021-9320
  • EISSN: 1469-7599
  • URL: /core/journals/journal-of-biosocial-science
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed