{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T22:18:02Z","timestamp":1775600282832,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Higher Education Research Promotion and Thailand\u2019s Education Hub for the Southern Region of ASEAN Countries Project Office of the Higher Education Commission","award":["TEH-AC:016\/2018"],"award-info":[{"award-number":["TEH-AC:016\/2018"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>This study aimed to assess the influences of stigma and HIV status on reproductive intention among heterosexual couples living with HIV in China.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was conducted in Kunming, China among 315 HIV-positive individuals and their spouses (n = 315 couples). An interview questionnaire was used to collect data on intention, desire, HIV Stigma Scale items, and HIV status. Dyadic fertility intention was examined using the actor-partner interdependence mediation model, based on the Traits-Desires-Intentions-Behavior framework.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The husbands\u2019 or wives\u2019 internalized stigma had significant negative effects on their own fertility desire (\u03b2 = \u22120.149, p&lt;0.05 and \u03b2 = \u22120.238, p&lt;0.01, respectively). HIV-positive status of the husbands was weakly linked to their own fertility intention (\u03b2 = \u22120.181, p&lt;0.05). Husbands\u2019 perceived provider stigma was associated with their own and their wives\u2019 fertility intention via the mediating effect of their fertility desire (\u03b2 = \u22120.374, p&lt;0.001 and \u03b2 = \u22120.203, p&lt;0.01, respectively). The cumulative influence of their reproductive desire mediated the husband\u2019s perceived provider stigma and the wife\u2019s internalized stigma on their fertility intention.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Stigma and HIV status were associated with fertility intention among couples living with HIV, mediated by fertility desire. The high intra-couple correlation suggested that counseling should be conducted when both spouses are present together with extensive discussions on concerns regarding HIV-related stigma, potential discrepancies between each partner\u2019s fertility desire and intention, and the influence of one partner on the other.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0278244","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T20:09:37Z","timestamp":1669925377000},"page":"e0278244","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Mediation of the association between stigma and HIV status and fertility intention by fertility desire among heterosexual couples living with HIV in Kunming, China"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2095-7988","authenticated-orcid":true,"given":"Yingwu","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wit","family":"Wichaidit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingrong","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-4463","authenticated-orcid":true,"given":"Virasakdi","family":"Chongsuvivatwong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"pone.0278244.ref001","first-page":"OC19","article-title":"Fertility Desires and Intentions among People Living with HIV\/AIDS (PLWHA) in Southern India","volume":"10","author":"H Jose","year":"2016","journal-title":"J Clin Diagn Res JCDR"},{"key":"pone.0278244.ref002","doi-asserted-by":"crossref","first-page":"2528","DOI":"10.1007\/s10461-013-0446-8","article-title":"HIV-related Stigma as a Barrier to Achievement of Global PMTCT and Maternal Health Goals: A Review of the Evidence","volume":"17","author":"JM Turan","year":"2013","journal-title":"AIDS Behav"},{"key":"pone.0278244.ref003","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/spc3.12022","article-title":"Dyadic Models for the Study of Health","volume":"7","author":"RG Reed","year":"2013","journal-title":"Soc Personal Psychol Compass"},{"key":"pone.0278244.ref004","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/01650250444000405","article-title":"The Actor\u2013Partner Interdependence Model: A model of bidirectional effects in developmental studies","volume":"29","author":"WL Cook","year":"2005","journal-title":"Int J Behav Dev"},{"key":"pone.0278244.ref005","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s10869-020-09724-1","article-title":"An Actor-Partner Interdependence Model of Work Challenge Stressors and Work-Family Outcomes: the Moderating Roles of Dual-Career Couples\u2019 Stress Mindsets","volume":"36","author":"Z Chen","year":"2021","journal-title":"J Bus Psychol"},{"key":"pone.0278244.ref006","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/0032472042000213712","article-title":"A framework for modelling fertility motivation in couples","volume":"58","author":"WB Miller","year":"2004","journal-title":"Popul Stud"},{"key":"pone.0278244.ref007","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1089\/apc.2014.0075","article-title":"Examining the Traits-Desires-Intentions-Behavior (TDIB) Model for Fertility Planning in Women Living with HIV in Ontario, Canada","volume":"28","author":"AC Wagner","year":"2014","journal-title":"AIDS Patient Care STDs"},{"key":"pone.0278244.ref008","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/13625187.2013.801072","article-title":"Child desire in women and men living with HIV attending HIV outpatient clinics: evidence from a European multicentre study","volume":"18","author":"C N\u00f6stlinger","year":"2013","journal-title":"Eur J Contracept Reprod Health Care Off J Eur Soc Contracept"},{"key":"pone.0278244.ref009","doi-asserted-by":"crossref","DOI":"10.1080\/13691058.2013.811289","article-title":"Fertility intentions among HIV-infected, sero-concordant Kenyan couples in Nyanza Province, Kenya","volume":"15","author":"M Withers","year":"2013","journal-title":"Cult Health Sex"},{"key":"pone.0278244.ref010","first-page":"163","article-title":"HIV-Related Stigma Among Healthcare Providers in Different Healthcare Settings: A Cross-Sectional Study in Kerman, Iran","volume":"9","author":"F Tavakoli","year":"2020","journal-title":"Int J Health Policy Manag"},{"key":"pone.0278244.ref011","article-title":"Understanding Global HIV Stigma and Discrimination: Are Contextual Factors Sufficiently Studied? (GAPRESEARCH)","volume":"16","author":"BX Tran","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0278244.ref012","doi-asserted-by":"crossref","first-page":"18640","DOI":"10.7448\/IAS.16.3.18640","article-title":"Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis","volume":"16","author":"IT Katz","year":"2013","journal-title":"J Int AIDS Soc"},{"key":"pone.0278244.ref013","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1007\/s10461-013-0437-9","article-title":"HIV Stigma Mechanisms and Well-Being Among PLWH: A Test of the HIV Stigma Framework","volume":"17","author":"VA Earnshaw","year":"2013","journal-title":"AIDS Behav"},{"key":"pone.0278244.ref014","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1186\/s12889-021-12268-5","article-title":"Relationship, partner factors and stigma are associated with safer conception information, motivation, and behavioral skills among women living with HIV in Botswana","volume":"21","author":"SA Gutin","year":"2021","journal-title":"BMC Public Health"},{"key":"pone.0278244.ref015","unstructured":"Assessment of Vehicular Pollution in China: Journal of the Air & Waste Management Association: Vol 51, No 5. [cited 19 Oct 2022]. Available: https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/10473289.2001.10464300."},{"key":"pone.0278244.ref016","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1037\/a0019651","article-title":"Detecting, measuring, and testing dyadic patterns in the actor\u2013partner interdependence model.","volume":"24","author":"DA Kenny","year":"2010","journal-title":"J Fam Psychol"},{"key":"pone.0278244.ref017","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/pere.12230","article-title":"Giving dyadic data analysis away: A user-friendly app for actor\u2013partner interdependence models","volume":"25","author":"L Stas","year":"2018","journal-title":"Pers Relatsh"},{"key":"pone.0278244.ref018","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1080\/13691058.2014.902103","article-title":"Desire for fertility among HIV-seroconcordant and -discordant couples in Lusaka, Zambia","volume":"16","author":"R Cook","year":"2014","journal-title":"Cult Health Sex"},{"key":"pone.0278244.ref019","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1089\/apc.2011.0225","article-title":"Desire for pregnancy and risk behavior in young HIV-positive women","volume":"26","author":"JL Finger","year":"2012","journal-title":"AIDS Patient Care STDs"},{"key":"pone.0278244.ref020","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1002\/nop2.849","article-title":"Childbearing intention and its associated factors: A systematic review","volume":"8","author":"M Hashemzadeh","year":"2021","journal-title":"Nurs Open"},{"key":"pone.0278244.ref021","doi-asserted-by":"crossref","first-page":"19972","DOI":"10.7448\/IAS.18.1.19972","article-title":"Community perceptions of childbearing and use of safer conception strategies among HIV-discordant couples in Kisumu, Kenya","volume":"18","author":"BT Breitnauer","year":"2015","journal-title":"J Int Aids Soc"},{"key":"pone.0278244.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189869","article-title":"Difficult decisions: Evaluating individual and couple-level fertility intentions and HIV acquisition among HIV serodiscordant couples in Zambia","volume":"13","author":"DL Joseph Davey","year":"2018","journal-title":"PLoS ONE"},{"key":"pone.0278244.ref023","doi-asserted-by":"crossref","first-page":"2916","DOI":"10.1007\/s10461-018-2170-x","article-title":"A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa","volume":"22","author":"D Joseph Davey","year":"2018","journal-title":"AIDS Behav"},{"key":"pone.0278244.ref024","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1186\/s12905-021-01492-1","article-title":"Patterns of changing pregnancy intentions among women living with HIV in Canada","volume":"21","author":"L Skerritt","year":"2021","journal-title":"Bmc Womens Health"},{"key":"pone.0278244.ref025","article-title":"Confucianism Chinese culture, and reproductive behavior","author":"Z. Tang","year":"1995","journal-title":"undefined"},{"key":"pone.0278244.ref026","first-page":"33","article-title":"Religious aspects of assisted reproduction","volume":"8","author":"H Sallam","year":"2016","journal-title":"Facts Views Vis ObGyn"},{"key":"pone.0278244.ref027","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/j.1559-1816.1995.tb01766.x","article-title":"Behavioral Intentions: Which Ones Predict Fertility Behavior in Married Couples?1","volume":"25","author":"W Miller","year":"2006","journal-title":"J Appl Soc Psychol"},{"key":"pone.0278244.ref028","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1037\/1091-7527.26.4.431","article-title":"Impacts of HIV\/AIDS Stigma on Family Identity and Interactions","volume":"26","author":"L Li","year":"2008","journal-title":"China. 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