Fertility desires and intentions of HIV-positive women of reproductive age in Ontario, Canada: a cross-sectional study.
Fertility desires and intentions of HIV-positive women of reproductive age in Ontario, Canada: a cross-sectional study.
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DOI：
10.1371/journal.pone.0007925
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发表时间：
2009-12-07
期刊：
影响因子：
3.7
通讯作者：
Ontario HIV Fertility Research Team
中科院分区：
文献类型：
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作者：
Loutfy MR;Hart TA;Mohammed SS;Su D;Ralph ED;Walmsley SL;Soje LC;Muchenje M;Rachlis AR;Smaill FM;Angel JB;Raboud JM;Silverman MS;Tharao WE;Gough K;Yudin MH;Ontario HIV Fertility Research Team
艾滋病毒阳性妇女的预期寿命和生活质量的改善，加上垂直传播的减少，可能会导致许多艾滋病毒阳性妇女考虑怀孕。为了明确这一人群的需求，并帮助制定适当的卫生服务计划，我们的研究旨在评估居住在加拿大安大略省的艾滋病毒阳性育龄妇女的生育愿望和意图。一项横断面研究的招募分层匹配地理分布的艾滋病毒阳性妇女育龄（18-52）生活在安大略省进行。2007年10月至2009年4月期间，研究人员从38个地点招募了女性，并邀请她们完成一项189项名为“艾滋病毒怀孕计划问卷”的自我管理调查，该调查旨在评估生育意愿、意图和行动。拟合逻辑回归模型，计算未调整和调整后生育意向显著预测因子的比值比。490名参与研究的艾滋病毒阳性妇女的中位年龄为38岁（IQR， 32-43岁），61%、52%、47%和74%分别出生在加拿大境外、居住在多伦多、非洲裔和目前正在接受抗逆转录病毒治疗。在所有受访者中，69% （95% CI, 64%-73%）希望生育，57% （95% CI, 53%-62%）打算在未来生育。在多变量模型中，生育意向的显著预测因子是：年龄较小（年龄<40岁）（p<0.0001）、非洲种族（p<0.0001）、居住在多伦多（p = 0.002）和较低的终生生育数量（p = 0.02）。居住在安大略省的艾滋病毒阳性育龄妇女渴望和打算怀孕的比例高于早期北美研究报告。这一比例与非洲人口的报告更为相似。保健提供者和决策者需要考虑增加对艾滋病毒阳性妇女怀孕计划的服务和支持。这在非洲移民水平较高的司法管辖区可能尤为重要。
Improvements in life expectancy and quality of life for HIV-positive women coupled with reduced vertical transmission will likely lead numerous HIV-positive women to consider becoming pregnant. In order to clarify the demand, and aid with appropriate health services planning for this population, our study aims to assess the fertility desires and intentions of HIV-positive women of reproductive age living in Ontario, Canada. A cross-sectional study with recruitment stratified to match the geographic distribution of HIV-positive women of reproductive age (18–52) living in Ontario was carried out. Women were recruited from 38 sites between October 2007 and April 2009 and invited to complete a 189-item self-administered survey entitled “The HIV Pregnancy Planning Questionnaire” designed to assess fertility desires, intentions and actions. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios of significant predictors of fertility intentions. The median age of the 490 participating HIV-positive women was 38 (IQR, 32–43) and 61%, 52%, 47% and 74% were born outside of Canada, living in Toronto, of African ethnicity and currently on antiretroviral therapy, respectively. Of total respondents, 69% (95% CI, 64%–73%) desired to give birth and 57% (95% CI, 53%–62%) intended to give birth in the future. In the multivariable model, the significant predictors of fertility intentions were: younger age (age<40) (p<0.0001), African ethnicity (p<0.0001), living in Toronto (p = 0.002), and a lower number of lifetime births (p = 0.02). The proportions of HIV-positive women of reproductive age living in Ontario desiring and intending pregnancy were higher than reported in earlier North American studies. Proportions were more similar to those reported from African populations. Healthcare providers and policy makers need to consider increasing services and support for pregnancy planning for HIV-positive women. This may be particularly significant in jurisdictions with high levels of African immigration.
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