Determinants of Fertility Desires among HIV Positive Women Living in the Western Highlands Province of Papua New Guinea

Abstract

The objective of this study was to identify determinants of fertility desires in HIV positive women living in the Western Highlands Province, Papua New Guinea, a male-dominated, patrimonial society. A cross-sectional study was conducted to collect data in February, 2010. Two hundred and ninety one HIV-infected women participated in personal interviews using a structured questionnaire. Sixty-six percent of the respondents were in polygamous relationships. Thirty-four percent of the participants desired a child in the future. Chi-square tests revealed that variables associated with desire for a child were age, marital status, number of children, current co-habitation with a partner, duration of time with a partner, receipt of the bride price, domestic physical violence, sexual activity in the previous three months, partner’s desire for a child, and current contraceptive use. Using multiple logistic regression, a partner’s positive desire for a child was the strongest predictor, with an odds ratio of 13.04 (95% CI = 5.6 -29.91). Fertility desires were largely influenced by dominant culturally sensitive issues and the family-oriented culture. The integration of effective counseling and reproductive healthcare service into HIV clinics is recommended. Holistic, culturally-relevant and family-oriented reproductive health counseling should provide more positive outcomes for both HIV-infected women and their children.