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首页> 外文期刊>Reproductive Health >Fertility and HIV following universal access to ART in Rwanda: a cross-sectional analysis of Demographic and Health Survey data
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Fertility and HIV following universal access to ART in Rwanda: a cross-sectional analysis of Demographic and Health Survey data

机译：卢旺达普遍接入艺术之后的生育和艾滋病毒：人口和健康调查数据的横截面分析

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Background HIV infection is linked to decreased fertility and fertility desires in sub-Saharan Africa due to biological and social factors. We investigate the relationship between HIV infection and fertility or fertility desires in the context of universal access to antiretroviral therapy introduced in 2004 in Rwanda. Methods We used data from 3532 and 4527 women aged 20–49 from the 2005 and 2010 Rwandan Demographic and Health Surveys (RDHS), respectively. The RDHSs included blood-tests for HIV, as well as detailed interviews about fertility, demographic and behavioral outcomes. In both years, multiple logistic regression was used to assess the association between HIV and fertility outcomes within three age categories (20–29, 30–39 and 40–49?years), controlling for confounders and compensating for the complex survey design. Results In 2010, we did not find a difference in the odds of pregnancy in the last 5?years between HIV-seropositive and HIV-seronegative women after controlling for potential biological and social confounders. Controlling for the same confounders, we found that HIV-seropositive women under age 40 were less likely to desire more children compared to HIV-seronegative women (20–29?years adjusted odds ratio (AOR)?= 0.31, 95% CI: 0.17, 0.58; 30–39?years AOR?=?0.24, 95% CI: 0.14, 0.43), but no difference was found among women aged 40 or older. No associations between HIV and fertility or fertility desire were found in 2005. Conclusions These findings suggest no difference in births or current pregnancy among HIV-seropositive and HIV-seronegative women. That in 2010 HIV-seropositive women in their earlier childbearing years desired fewer children than HIV-seronegative women could suggest more women with HIV survived; and stigma, fear of transmitting HIV, or realism about living with HIV and prematurely dying from HIV may affect their desire to have children. These findings emphasize the importance of delivering appropriate information about pregnancy and childbearing to HIV-infected women, enabling women living with HIV to make informed decisions about their reproductive life.
机译：由于生物和社会因素，背景艾滋病毒感染与撒哈拉以南非洲的生育率和生育率下降有关。我们调查艾滋病毒感染和生育或生育期之间的关系在普遍获得2004年在卢旺达引入的抗逆转录病毒治疗的背景下的关系。方法分别从2005年和2010年卢旺达人口统计和健康调查（RDHS）的3532和4527名女性中使用了来自3532和4527名女性的数据。 RDHS包括艾滋病毒的血液试验，以及关于生育，人口和行为结果的详细面试。在这两年中，使用多元逻辑回归来评估三个年龄类别（20-29,30-39和40-49？年内的艾滋病毒和生育结果之间的关联，控制混淆并补偿复杂的调查设计。结果2010年，我们在控制潜在生物和社会混淆后，艾滋病毒血清阳性和艾滋病毒血清患者患者之间的怀孕几年没有找到差异。控制同样的混乱，我们发现，与艾滋病毒血清患者相比，40岁以下40岁以下的艾滋病毒血清阳性女性的可能性不太可能渴望更多的儿童（20-29岁以下的赔率比（AOR）？= 0.31,95％CI：0.17 ，0.58; 30-39？岁月？=？0.24,95％CI：0.14,0.43），但在40岁或以上的女性中没有发现差异。在2005年发现艾滋病毒和生育能力或生育欲望之间没有任何关联。结论这些研究结果表明HIV-SEROPIDIVIVE和HIV-SERONEGADIVAIVAIV妇女的出生或目前妊娠没有差异。在2010年的艾滋病毒血液阳性女性早期的育龄女性期间，比艾滋病毒的血液妇女所希望的孩子们可以提出更多患有艾滋病毒的女性幸存下来;和耻辱，害怕传播艾滋病病毒或与艾滋病毒过早死亡的现实主义可能会影响他们有孩子的愿望。这些调查结果强调了为艾滋病毒感染妇女提供有关妊娠和生育的适当信息的重要性，使艾滋病病毒感染的妇女能够为其生殖生活做出明智的决定。

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