According to the 2020 Joint United Nations Program on HIV/AIDS (UNAIDS) report, there were 38 million people living with HIV (PLHIV) globally, of whom 36.2 million were adults aged 15 years and older. Around 68% of adults living with HIV had accessed antiretroviral therapy (ART), of whom 73% were females and 61% were males .Like every individual, these adults living with HIV want to get married and have a newborn child. But, in previous times, individuals may have hesitated to engage in fertility because of fear of mother-to-child transmission (MTCT) of the virus, poor health status, stigma and lack of support from others[2, 3]. Nowadays, these challenges are reduced due to the availability of antiretroviral (ARV) drugs[4, 5].
Fertility desire is an individual's intention at reproductive age to have more children among PLHIV, which is improved by the introduction of ART . The life expectancy and overall quality of life of PLHIV have noticeably increased due to the use of highly active antiretroviral therapy (HAART) [7, 8]. Similarly, the rate of MTCT of HIV has decreased to less than 5% as a result of the effective use of ARV drugs . This in turn results in an increased desire among HIV-infected individuals for pregnancy and child bearing[10–12].The desire for childbearing can also have significant public health importance among PLHIV because they feel that having more children will increase the chance of being retired by their offspring.
Although HIV can affect a person's whole life, it does not prevent people living with HIV from having children. Like HIV-uninfected individuals, PLHIV have sexual and reproductive health needs, including the ability to make an informed decision about how many and when to have children. Studies in different areas of the world have shown that a significant proportion of PLHIV wish to be parents. A study conducted in thirteen European countries showed the prevalence of the desire for fertility was 43%. Other studies conducted in Brazil and Spain revealed that the prevalence of fertility desire among people on ART was 25.9%  and 49%, respectively. Studies conducted in Asian countries including Georgia, India, Indonesia, Nepal, and China showed the prevalence of fertility desire among PLHIV ranged from 12.1–50.8%[2–4, 13, 17].
As more human beings get admission to antiretroviral therapy (ART) and live healthier and longer lives with human immunodeficiency virus (HIV) in sub-Saharan Africa, their choice of destiny to be pregnant is increasing.Studies conducted in Nigeria showed that the prevalence of fertility desire among PLHIV ranged from 47.5 to 75.8% [7, 19, 20]. Other studies conducted in Tanzania, Nairobi, Malawi, and Uganda revealed that the prevalence of fertility desire among PLHIV was 17, 34, 51, and 59%, respectively[21–24]. Similarly, in Ethiopia, the desire for fertility in the future among PLHIV was reported and ranged from 33.4–58.8% [6, 8, 9, 11, 25–29].
PLHIV's desire for future childbearing has been linked to a variety of socio-demographic, current health condition, cultural, and social factors. As a result, increased desire for childbearing has been linked to younger age, male sex, education, marriage, having no or few children, improved health, increased CD4 + T-cell count, duration on ART, community pressure, and having good PMTCT knowledge [2, 3, 9, 15, 17, 20, 21, 23, 25, 27].
Although there are studies in Ethiopia, we find it important to do so because most of the studies are on women, and the desire to have children is not limited to women. Similarly, the target population of previous studies was HIV-infected people, either on ART or not, which may have underestimated or overestimated the results. So, in order to see the clear effect of ART on fertility desire in both men and women, this study was conducted. Therefore, this study aimed to assess the prevalence of fertility desire and its determinant factors among PLWHIV.