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While many HIV-infected individuals do not wish to have children, others want children despite their infected status. The desire and intent to have children among HIV-infected individuals may increase because of improved quality of life and survival following commencement of antiretroviral treatment. In developing countries such as South Africa, where the largest number of people living with HIV/AIDS worldwide reside, specific government reproductive health policy and service provision for HIV-infected individuals is underdeveloped. This policy brief presents findings from a qualitative study that explored HIV-infected individuals’ reproductive intentions, decision-making, and need for reproductive health services. The study also assessed the opinions of health-service providers, policymakers, and influential figures within nongovernmental organizations who are likely to play important roles in the shaping and delivery of reproductive health services. Conducted at two health centers in the Cape Town metropolitan area in South Africa from May 2004 to January 2005, the study focused on issues that impact reproductive choice and decision-making and identified critical policy, health service, and research-related matters to be addressed.