Mentored Scientist Award

Understanding Women Living with HIV’s Perceptions of the Relationship between HIV, ART, and Fertility

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Award amount - Direct


A recent meta-analysis showed that in sub-Saharan Africa, approximately one in five couples experience infertility, defined as the inability to become pregnant after 12 months of unprotected intercourse. Women living with HIV face even higher infertility rates compared to their HIV negative counterparts. In Kenya, adolescents and young women are contracting HIV faster than any other subgroup and carry twice the burden of HIV compared to men (6.6% vs 3.1% respectively). The combination of HIV and infertility could be devastating for women in Sub-Saharan Africa, where a woman's worth is often linked to motherhood. In 2015, the WHO recommended that all people living with HIV take ART regardless of CD4 count. Since then, recent evidence in this new era of widespread ART use, shows that adhering to ART can attenuate the impact of HIV on infertility. 

However, given this new evidence and ART landscape, there are complete gaps in knowledge around this phenomenon. Improving our understanding of women’s perceptions of the relationship between HIV, ART, and infertility could improve ART adherence and guide programs to help women with HIV reach their reproductive and HIV treatment goals. 

This RAP proposal will enable me to work with a new population that has higher rates of infertility (both perceived and real): women living with HIV. The objectives of the proposed research are to synthesize the existing literature on knowledge and perceptions around how HIV and ART affect fecundity (Aim 1) and to understand perceptions of how HIV and ART affects fecundity among women living with HIV (Aim 2). To meet these objectives, leveraging the infrastructure from my mentor, Dr. Gandhi, who is conducting a women’s health and HIV R01 in the same region, I will conduct a scoping review and 30 in-depth interviews with women living with HIV near Nairobi, Kenya.