Sampling design
The sample size for the study was decided based on 5 % marginal of error and 80 % power with 95 % confidence level. Considering the measure of interest, namely couple protection rate of 50 %, the following statistical formula was used.
$$ \left(\mathrm{Z}2\kern0.5em *\kern0.5em \mathrm{p}\mathrm{q}\right)/{\mathrm{d}}^2; $$
Using the above formula, the required sample size is 384. However, the sample was increased accounting a design effect of 1.7 as well non-response of 10 % m the required sample size was around 720.
We recruited a total of 720 young (15–29 years) HIV positive currently married women. Of the 720 participants recruited, 633 participated (87 % response), and were administered a structured, pre-tested questionnaire in a face-to-face interview. The sample size for the study was restricted to married women, as in the context of Karnataka, childbearing is an option mainly for married women.
The Jeevan Jyothi community-based organization (CBO) in Bagalkot district is one of the earliest CBOs formed for HIV positive people in Karnataka state. The Jeevan Jyothi has established a drop-in centre (DIC) for HIV positive people in the district to access various HIV related services. Most of the (approximately 4,000) women registered with the DIC consented to be contacted, and about 2,000 were in the age group 15–29 years and were included in the sampling frame. The required sample of respondents (720) was then selected using a stratified random sampling approach, where age was considered as a stratification variable. Currently married women were stratified into 3 age groups: 15–19 years, 20–24 years and 25–29 years, and then the required number of respondents were randomly selected from each strata proportionately.
Data collection
The field team included, 6 female interviewers and 1 supervisor. All the field investigators were at least graduates with significant field experience in collecting data. All the field team members were given one week intensive training, which included, class room lectures, orientation on questionnaire, mock interviews, visit to Jeevan Jyoti and field practices. In addition, they were trained on conducting interviews and ethics of researches. A special training was given to the supervisor in data quality control, use of monitoring tools, preparation of progress report, inter-personal communication with staff and others etc. The field work was carried out during July-August 2012.
The study used a structured interview questionnaire which was administered to each selected participant. The study questionnaire included information on fertility preferences of Women Living with HIV/AIDS, socio-economic and demographic characteristics, reproductive behaviour and contraceptive use, fertility behaviour after having HIV/AIDS, reproductive and sexual health etc.
Data analysis
The study used SPSS 22.0 statistical software, and bivariate as well as multivariate analyses were carried out. Each respondent in the survey was asked “if she ever had pregnancy that ended in still birth, spontaneous or induced abortion?”. If she had experienced any, then questions were also asked how many still births, induced and spontaneous abortions. The present study included any women reported experience of still births or abortions. We compared reported pregnancy wastages among two groups of women, the group of women who became pregnant after their HIV positive status vs. the group who did not become pregnant after their HIV positive status but had pregnancies prior to HIV positive status. Multivariate logistic regression models were used to understand the correlates of reported pregnancy wastage, incorporating a set of independent variables, including place of usual residence, literacy level, occupation, age at living with current husband, duration of marriage, literacy of husband, occupation of husband, caste, type of house, type of family, monthly household income, number of living children and duration since HIV tested.
Ethical considerations
Ethical clearance was obtained from the World Health Organization’s Research Ethics Review Committee, the Institutional Ethical Review Board of St John’s Medical College, Bangalore, and the Health Research Ethics Board of the University of Manitoba, Winnipeg, Canada.