Enough Children: Reproduction, Risk, and “Unmet Need” among People Receiving Antiretroviral Treatment in Western Uganda

Amy Kaler, University of Alberta

In this paper, I examine complex and contradictory evidence concerning fertility intentions among households in rural Uganda participating in a community-based antiretroviral distribution program. This paper is based on interviews and surveys (n=87). I contextualize my evidence with the operations literature on the intersection of family planning demand and HIV/AIDS. I claim that actual "unmet need" for family planning cannot be projected, as people on treatment face discordant influences on the desire for another child. While the normative response to survey questions is to say that pregnancy while on treatment is undesirable, more in-depth interview evidence suggests that people both desire and do not desire more children, often at the same time.