Sexual Behaviour, Needs and Concerns Regarding Sexual and Reproductive Health among Adults Living with HIV in Sub-Saharan Africa- A Systematic Review
Journal of Advances in Medicine and Medical Research,
Background: The sexual and reproductive health of people living with HIV in sub-Saharan Africa should be of paramount importance and, therefore, given the attention it deserves. The advent of antiretroviral therapy (ART) and subsequent access to it has aided millions of infected people to live a normal life. However, being on ART is not enough as most of these people despite being on the therapy are faced with needs and concerns that have shaped their sexual behaviour.
This review aims to bring to perspective the sexual behaviour, needs, and concerns regarding the sexual and reproductive health of adults living with HIV in sub-Saharan Africa (SSA) with a view to reducing the disease's ultimate burden in the region.
Method: An extensive search of articles was carried out using the reporting systematic review and meta-analysis (PRISMA). The database search was from JSTORE, Scopus, Google Scholar, Medline, Cochrane, Semantic scholar, and Pubmed.
Results: A total of 3,984 results were obtained from the search. The application of the inclusion and exclusion criteria finally gave ten studies which were reviewed. The review revealed, among other things, that a good number of adults living with HIV have multiple sex partners, and some still have sex without condoms. Besides, most of them indicated the need for their own biological children, especially after being on ART for a while. Some women living with HIV in SSA do not have a right to decide on their sexual and reproductive health.
Recommendation: It was recommended that there be intense re-orientation and health education for this group of people. Women need to be empowered and taught their rights.
- sexual and reproductive health
- family planning
- sexual behaviour
- sub-Saharan Africa.
How to Cite
Retrieved 25th June 2020.
UNAIDS. AIDS info; 2019a.
Retrieved 25th June 2020.
Kharsany AB, Karim QA. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities. The Open AIDS Journal. 2016;10:34-48.
Cooper D, Moodley J, Zweigenthal V, Bekker LG, Shah I, Myer L. Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services. AIDS and Behavior. 2009;13(1):38.
Olakunde BO, Adeyinka DA, Olawepo JO, Pharr JR, Ozigbu CE, Wakdok S, et al. Towards the elimination of mother-to-child transmission of HIV in Nigeria: a health system perspective of the achievements and challenges. International Health. 2019;11(4):240-249.
Brown TT, Glesby MJ. Management of the metabolic effects of HIV and HIV drugs. Nature Reviews Endocrinology. 2012;8(1):11.
Venkatesh KK, Srikrishnan A, Safren SA, Triche EW, Thamburaj E, Prasad L, et al. Sexual risk behaviors among HIV-infected South Indian couples in the HAART era: implications for reproductive health and HIV care delivery. AIDS Care. 2011;23(6):722-733.
Nöstlinger C, Desjardins F, Dec J, Platteau T, Hasker E, Group EVS. Child desire in women and men living with HIV attending HIV outpatient clinics: Evidence from a European multicentre study. The European Journal of Contraception Reproductive Health Care. 2013b;18(4):251- 263.
Dyer SJ, Abrahams N, Mokoena N, van der Spuy ZM. ‘You are a man because you have children’: Experiences, reproductive health knowledge and treatment‐seeking behaviour among men suffering from couple infertility in South Africa. Human Reproduction. 2004;19(4):960-967.
Pinyopornpanish K, Thanamee S, Jiraporncharoen W, Thaikla K, McDonald J, Aramrattana A, et al. Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey. BMC Research Notes. 2017;10(1):682.
Breiding MJ, Smith SG, Basile KC, Walters ML, Chen J, Merrick MT. Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—National Intimate Partner and Sexual Violence Survey, United States, 2011. American Journal of Public Health. 2015;105(4):e11-e12.
Thanh DC, Hien NT, Tuan NA, Thang BD, Long NT, Fylkesnes K. HIV risk behaviours and determinants among people living with HIV/AIDS in Vietnam. AIDS and Behavior. 2009;13(6):1151.
Ncube B, Ansong J, Daniels K, Campbell-Stennett D, Jolly PE. Sexual risk behavior among HIV-positive persons in Jamaica. African Health Sciences. 2017;17(1):32-38.
Nedjat S, Moazen B, Rezaei F, Hajizadeh S, Majdzadeh R, Setayesh HR, et al. Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: A mixed-method descriptive study. International Journal of Health Policy Management. 2015;4(9):591.
Pearson CR, Cassels S, Kurth AE, Montoya P, Micek MA, Gloyd SS. Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans. AIDS Behavior. 2011;15(4):778-787.
Orner P, Cooper D, Myer L, Zweigenthal V, Bekker LG, Moodley J. Clients’ perspectives on HIV/AIDS care and treatment and reproductive health services in South Africa. AIDS Care. 2008;20(10):1217-1223.
Nöstlinger C, Desjardins F, Dec J, Platteau T, Hasker E, Group EVS. Child desire in women and men living with HIV attending HIV outpatient clinics: Evidence from a European multicentre study. The European Journal of Contraception & Reproductive Health Care. 2013a;18(4):251-263.
Nattabi B, Li J, Thompson SC, Orach CG, Earnest J. A systematic review of factors influencing fertility desires and intentions among people living with HIV/AIDS: implications for policy and service delivery. AIDS and Behavior. 2009;13(5): 949-968.
Van Zyl C, Visser MJ. Reproductive desires of men and women living with HIV: implications for family planning counselling. Reproductive Biomedicine Online. 2015;31(3):434-442.
Mmbaga EJ, Leyna GH, Ezekiel MJ, Kakoko DC. Fertility desire and intention of people living with HIV/AIDS in Tanzania: a call for restructuring care and treatment services. BMC Public Health. 2013;13(1):86.
Ssali SN, Atuyambe L, Tumwine C, Segujja E, Nekesa N, Nannungi A, et al. Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care and STDs. 2010;24(10):675-681.
Kaida A, Laher F, Strathdee SA, Janssen PA, Money D, Hogg RS, et al. Child-bearingg intentions of HIV-positive women of reproductive age in Soweto, South Africa: The influence of expanding access to HAART in an HIV hyperendemic setting. American Journal of Public Health. 2011;101(2):350-358.
Mmeje O, Njoroge B, Cohen CR, Temmerman M, Vermund SH, van der Poel S. Achieving pregnancy safely in HIV-affected individuals and couples: an important strategy to eliminate HIV transmission from mother-to-child and between sexual partners. AIDS Journal of Acquired Immune Deficiency Syndromes. 2015;70(4):e155-e159.
Jones DL, Rodriguez VJ, Babayigit S, Chahine A, Weiss SM, Peltzer K. Reproductive decision-making among postpartum HIV-infected women in rural South Africa. International Journal of Std Aids. 2018;29(9):908-916.
Ayieko J, Ti A, Hagey J, Akama E, Bukusi EA, Cohen CR, et al. HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: Insights from a qualitative study. Reproductive Health. 2017;14(1):93.
Abeje G, Motbaynor A. Demand for family planning among HIV positive women on ART: the case of South Gondar and North Wollo Zones Amhara region. BMC Research Notes. 2016;9(1):43.
McCoy SI, Buzdugan R, Ralph LJ, Mushavi A, Mahomva A, Hakobyan A, et al. Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe. PloS One. 2014;9(8):e105320.
Beymer MR, Holloway IW, Pulsipher C, Landovitz RJ. Current and future PrEP medications and modalities: On-demand, injectables, and topicals. Journal of Current HIV/AIDS Reports. 2019;16(4): 349-358.
Etokidem A, Ndifon W, Etowa J, Asuquo E. Family planning practices of rural community dwellers in cross river state, Nigeria. Nigerian Journal of Clinical Practice. 2017;20(6): 707-715.
Schivone GB, Blumenthal PD. Contraception in the developing world: Special considerations. Seminars in Reproductive Medicine. 2016;34(03):168-174.
Machiyama K, Casterline JB, Mumah JN, Huda FA, Obare F, Odwe G, et al. Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study. Reproductive Health. 2017;14(1):23.
WHO. Family Planning/Contraception Methods; 2020.
Retrieved 27th June 2020.
Feyissa TR, Melka AS. Demand for modern family planning among married women living with HIV in western Ethiopia. PloS One. 2014;9(11).
Abubeker FA, Fanta MB, Dalton VK. Unmet need for contraception among HIV-positive women attending HIV care and treatment service at saint Paul’s hospital millennium medical college, Addis Ababa, Ethiopia. International Journal of Reproductive Medicine; 2019.
Mak WW, Cheung RY, Law RW, Woo J, Li PC, Chung RW. Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS. Social Science & Medicin. 2007;64(8):1549-1559.
Bigna JJ, Tounouga DN, Kenne AM, Djikeussi TK, Foka AJ, Um LN, et al. Epidemiology of depressive disorders in people living with HIV in Africa: A systematic review and meta-analysis: Burden of depression in HIV in Africa. General Hospital Psychiatry. 2019;57:13-22.
Bravo P, Edwards A, Rollnick S, Elwyn G. Tough decisions faced by people living with HIV: A literature review of psychosocial problems. Aids Rev. 2010;12(2):76-88.
UNFPA. Sexual & Reproductive Health; 2020.
Retrieved 2nd July 2020.
Gruskin S, Ferguson L, O'Malley J. Ensuring sexual and reproductive health for people living with HIV: An overview of key human rights, policy and health systems issues. Reproductive Health Matters. 2007;15(sup29):4-26.
Coyne KM, Hawkins F, Desmond N. Sexual and reproductive health in HIV-positive women: A dedicated clinic improves service. International Journal of STD. 2007;18(6):420-421.
Abebe M, Addissie A, Regassa T. Fertility desire and contraceptive utilization among people living with HIV/AIDS on ART in Hosanna Town, Southern Ethiopia. Science, Technology, Arts Research Journal. 2012a;1(4):38-46.
Mersha AG, Erku DA, Belachew SA, Ayele AA, Gebresillassie BM, Abegaz TM. Contraceptive use among HIV-positive and negative women: implication to end unintended pregnancy. Journal of Contraception Reproductive Medicine. 2019;4(1):3.
Bell E, Mthembu P, O'Sullivan S, Moody K, HIV/AIDS ICoWLw. Sexual and reproductive health services and HIV testing: perspectives and experiences of women and men living with HIV and AIDS. Reproductive Health Matters. 2007;15(29):113-135.
Bharat S, Mahendra VS. Meeting the sexual and reproductive health needs of people living with HIV: challenges for health care providers. Reproductive Health Matters. 2007;15(sup29):93-112.
Kober K, Van Damme W. Scaling up access to antiretroviral treatment in southern Africa: who will do the job? The Lancet. 2004;364(9428):103-107.
Tumukunde D, Nuwaha F, Ekirapa E, Kityo C, Ssali F, Mugyenyi P. Sexual behaviour among persons living with HIV/AIDS in Kampala, Uganda. East African Medical Journal. 2010;87(3):91-99.
Wagner GJ, Wanyenze R. Fertility desires and intentions and the relationship to consistent condom use and provider communication regardingchild-bearingg among HIV clients in Uganda. International Scholarly Research Notices; 2013.
Wanyenze RK, Matovu JK, Kamya MR, Tumwesigye NM, Nannyonga M, Wagner GJ. Fertility desires and unmet need for family planning among HIV infected individuals in two HIV clinics with differing models of family planning service delivery. BMC Women's Health. 2015; 15(1):1-12.
Abasiubong F, Udoh SB, Idung AU, Umoiyoho AJ. Attitudes and sexual behaviours of unmarried people with HIV/AIDS living in the Niger Delta region of Nigeria. Mental Health in Family Medicine. 2012;9(4):225.
Abubakar IS, Kabir M, Babashuni M, Shuaib F, Aliyu MI. Correlates of fertility intentions among HIV/AIDS patients in Northern Nigeria. African Journal of Reproductive Health. 2018;13(3).
Abebe M, Addissie A, Regassa T. Fertility desire and contraceptive utilization among people living with HIV/AIDS on ART in Hosanna Town, Southern Ethiopia. Science, Technology and Arts Research Journal. 2012b;1(4):38-46.
Venkatesh KK, De Bruyn G, Lurie MN, Modisenyane T, Triche EW, Gray GE, et al. Sexual risk behaviors among HIV-infected South African men and women with their partners in a primary care program: implications for couples-based prevention. AIDS and Behavior, 2012;16(1):139-150.
Gombachika BC, Chirwa E, Malata A, Sundby J, Fjeld H. Reproductive decisions of couples living with HIV in Malawi: What can we learn for future policy and research studies? Malawi Medical Journal. 2013;25(3):65-71.
Kwenti TE, Nsagha DS, Kwenti BDT, Njunda AL. Sexual risk behaviours among people living with HIV and implications for control in the north west region of Cameroon. World Journal of AIDS; 2014.
Yaya I, Saka B, Landoh DE, Makawa MS, Senanou S, Idrissou D, et al. Sexual risk behavior among people living with HIV and AIDS on antiretroviral therapy at the regional hospital of Sokodé, Togo. BMC Public Health. 2014;14(1):1-6.
Eisele TP, Mathews C, Chopra M, Lurie MN, Brown L, Dewing S, Kendall C. Changes in risk behavior among HIV-positive patients during their first year of antiretroviral therapy in Cape Town South Africa. AIDS and Behavior. 2009;13(6):1097-1105.
Shewamene Z, Legesse B, Tsega B, Bhagavathula AS, Endale A. Consistent condom use in HIV/AIDS patients receiving antiretroviral therapy in northwestern Ethiopia: Implication to reduce transmission and multiple infections. HIV/AIDS (Auckland, NZ). 2015;7: 119.
Molla AA, Gelagay AA. Risky sexual practice and associated factors among HIV positive adults attending anti-retroviral treatment clinic at Gondar University Referral Hospital, Northwest Ethiopia. PloS One. 2017;12(3):e0174267.
Tadesse WB, Gelagay AA. Risky sexual practice and associated factors among HIV positive adults visiting ART clinics in public hospitals in Addis Ababa city, Ethiopia: A cross sectional study. BMC Public Health. 2019;19(1):1-8.
Myer L, Carter RJ, Katyal M, Toro P, El-Sadr WM, Abrams EJ. Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: A cohort study. PLoS Med. 2010;7(2):e1000229.
Abstract View: 251 times
PDF Download: 108 times