Fertility Desire and Associations with Condomless Sex, Antiretroviral Adherence, and Transmission Potential in a Cohort of Kenyan Women Living with HIV in Sero-discordant Relationships: A Mixed Methods Study
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Published:2023-02-09
Issue:8
Volume:27
Page:2803-2814
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ISSN:1090-7165
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Container-title:AIDS and Behavior
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language:en
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Short-container-title:AIDS Behav
Author:
Eastment McKenna C.ORCID,
Kinuthia John,
Tapia Kenneth,
Wanje George,
Wilson Katherine,
Kaggiah Anne,
Simoni Jane M.,
Mandaliya Kishorchandra,
Poole Danielle N.,
Richardson Barbra A.,
Jaoko Walter,
John-Stewart Grace,
McClelland R. Scott
Abstract
AbstractFor women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal secretions, a marker for recent condomless sex, was lowest in women with fertility desire and highest in women with fertility intent. Detectable viral load followed a similar pattern. Risk of HIV transmission, when condomless sex and PSA detection occurred concurrently, was three to fourfold higher at visits with fertility intent compared to visits with fertility desire. Qualitative interviews underscored the importance women place on childbearing and suggested that they had limited information about the role of antiretroviral therapy in reducing sexual HIV transmission.
Funder
National Institute of Child Health and Human Development
National Institute of Mental Health
Center for AIDS Research, University of Washington
Division of Cancer Prevention, National Cancer Institute
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health,Social Psychology