Mediation of the association between stigma and HIV status and fertility intention by fertility desire among heterosexual couples living with HIV in Kunming, China.

Abstract

ObjectivesThis study aimed to assess the influences of stigma and HIV status on reproductive intention among heterosexual couples living with HIV in China.MethodsA cross-sectional study was conducted in Kunming, China among 315 HIV-positive individuals and their spouses (n = 315 couples). An interview questionnaire was used to collect data on intention, desire, HIV Stigma Scale items, and HIV status. Dyadic fertility intention was examined using the actor-partner interdependence mediation model, based on the Traits-Desires-Intentions-Behavior framework.ResultsThe husbands' or wives' internalized stigma had significant negative effects on their own fertility desire (β = -0.149, pConclusionsStigma and HIV status were associated with fertility intention among couples living with HIV, mediated by fertility desire. The high intra-couple correlation suggested that counseling should be conducted when both spouses are present together with extensive discussions on concerns regarding HIV-related stigma, potential discrepancies between each partner's fertility desire and intention, and the influence of one partner on the other.