HIV Status, Fertility Intentions, and the Demand for Contraception: Assessing the Current Research to Improve the Integration of Reproductive Health and HIV Programs

Naomi Rutenberg, Population Council
Duff G. Gillespie, Johns Hopkins University
Elizabeth Flanagan, Johns Hopkins Bloomberg School of Public Health
Sabrina Karklins, Johns Hopkins Bloomberg School of Public Health
Heather M Bradley, Johns Hopkins Bloomberg School of Public Health

In order to assess what information can currently be brought to bear on the question of demand for children and contraception among people living with HIV/AIDS, we reviewed 190 studies to identify (1) the strength and nature of the association between HIV and reproductive intentions; and (2) key confounders and conditioning factors. Preliminary results suggest a considerable amount of heterogeneity in the effect of HIV status on fertility intentions, contraceptive use and pregnancy. For example, developed country studies found an association between knowing HIV-positive status and decreased pregnancy rates prior to the introduction of highly effective antiretroviral therapy but not after, while no such dampening effect of HIV status on pregnancy rates was found in developing countries. Main outcomes of this analysis will be the identification of gaps and priorities for research as well as informing current discussions about how to integrate and effectively use both reproductive health and HIV program resources.