HIV-seropositivity is not important in childbearing decision-making among HIV-positive Ghanaian women receiving antiretroviral therapy Amos K. Laar a *, Araba E. Taylor a and Bismark A. Akasoe b a Department of Population, Family, & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana; b Catholic Bishop’ s Secretariat, Health Office, Bolgatanga, Ghana (Received 21 September 2014; accepted 8 January 2015) Women in their reproductive years make up about 50% of all HIV-positive persons globally. These women, just as their HIV-negative counterparts, wield the right to procreate. However, HIV infection and lack of appropriate information on reproductive options may negatively impact women’ s procreative decision-making. This study assessed fertility intentions of HIV-positive women receiving antiretroviral therapy (ART) in southern Ghana. Quantitative methods were used to collect data from HIV-positive women receiving ARTat four treatment centers. HIV-positive aged 18–49 years, and receiving ART were selected using systematic random sampling technique. Three hundred eighteen women were interviewed after informed consent. We used univariate analysis to generate descriptive tabulations for key variables. Bivariate analysis and logistic regression modeling respectively produced unadjusted and adjusted associations between background attributes of respondents and their childbearing decision-making. All analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Irrespective of age, reproductive history, and duration of HIV diagnosis, 46% of the women were desirous of procreating. The bivariate level analysis shows that women in their late reproductive ages (30–39 years) had the strongest desire to procreate (p < 0.001). After controlling for a number of covariates, primiparous and secundiparious women were about twice as likely to desire children (aOR = 2.553; 95% CI 1.480–4.401), and so were women aged 30–39 years (aOR = 2.149; 95% CI 1.202–3.843). Of 54% women who do not wish to procreate, achievement of desired family size (64.3%) was more popular a reason than fear of vertical transmission of HIV (7.5%), poor health status (5%), and pregnancy-related complications (1.6%). Keywords: fertility intentions; childbearing decision-making; HIV-seropositivity; ART; Ghana Introduction The rate of HIV-related morbidity and mortality has decreased profoundly since the widespread availability of antiretroviral (ARV) drugs (UNAIDS, 2013). Accord- ing to a recent global AIDS epidemic update, there were 35.3 million persons living with HIV/AIDS and over 50% of the infected adults were women in their reproductive age (UNAIDS, 2013). To those who qualify, reproduction is a natural right. Every person, regardless of their health status may at a time deemed appropriate by them, wish to express this fundamental right. Persons infected with HIV are right-bearers. In line with this reasoning, two separate studies involving ARV- exposed HIV-positive women in their reproductive ages found that a good number of them were sexually active, and desirous of having children (Aska, Chompikul, & Keiwkarnka, 2011; Loutfy et al., 2009). Some of the women (HIV-positive women living in Ontario, Canada), according to Loutfy et al. had taken certain steps such as seeing a doctor and not using any contraceptive in order to conceive. On the contrary, Kanniappan et al. showed that HIV diagnosis influences the reproductive choices of women (Kanniappan, Jeyapaul, & Kalyanwala, 2008). A related study conducted in the UK among HIV- positive women receiving treatment revealed that most of them desired to have more children (Cliffe, Townsend, Cortina-Borja, & Newell, 2011). Some of these women had tried unproductively to become pregnant and even resorted to medical treatment to help achieve their desires. About a third of the women specifically stated that being diagnosed of HIV did not affect their fertility decision-making (Cliffe et al., 2011). Another study conducted in rural Mozambique to compare the fertility intentions of HIV-positive and HIV-negative clients reported that HIV-positive clients were less desirous of having children. Such decisions were associated with age, parity, HIV status, economic status, and educational level of clients (Hayford, Agadjanian, & Luz, 2012). Some of these women were also on antiretroviral therapy (ART). It is worthy of note that the childbearing decision-making of women on ART (as reported above) may vary with those who lived during the pre-ART era. Beyond the above-mentioned clinical and individual level determinants of childbearing decision-making are contextual sociocultural determinants. For instance, in most African countries the value of a woman is mostly *Corresponding author. Email: alaar@ug.edu.gh © 2015 Taylor & Francis AIDS Care, 2015 Vol. 27, No. 7, 870–875, http://dx.doi.org/10.1080/09540121.2015.1007115