Id they did not want any more children. One male participant was not sure whether he wanted more children. Hence more men (9/12) than women wanted to have children. However, regardless of the differences in desire to have children, almost all of the PLHIV had made a reassessment of their ability to have more children and generally accepted that they could not have as many as they wanted. There was generally high level of knowledge around HIV transmission, particularly MTCT of HIV. Thus the decisionmaking process around having children was complex: the men and women interviewed knew the implications of having children, given their HIV status and the possibility of infecting their children. The themes around the desire to have children among the 26 participants included decision making (reassessment of reproductive career, male dominance and fatalism), external influences (order ��-Amatoxin spouses, family and health workers, and access to HAART and PMTCT services), culturalinfluences (heirs and inheritance), health concerns (personal health concerns and concerns for children’s health), stigma and attitudes to children (as sources of joy, utilitarian roles, strengthening marriages). Children were seen as sources of joy and blessings by most of the participants. The participants who had delivered children after their HIV diagnosis were pleased that they could have children and were particularly happy when they had HIV-negative children. Other participants spoke about the utilitarian function of children and how they would be a help in the future. A widow and mother of five children encapsulated the utilitarian function of children when she said: If they grow up they will also help you when you are now helpless. They will take you to hospital if you are very sick, dig for you, feed you and give you other help. Several female participants emphasized the role of children in strengthening marriages. A 20-year-old female participant, said: I think in marriage it means a lot to have children, because it makes a happy marriage, increase love among the two people. However, it was not just women who felt that children were essential for cementing relationships. Although several male participants had children with former spouses, they wanted to have children with their current partners. One male participant said that people would mock and query their inability to have children and this would lead to the wife deserting him: To my wife the issue is even more important because if you don’t have children with a woman she will not agree to live with you . . . The reason why I want to have a child is if you have a woman and don’t bear children with her your relationship will not be strong or good. Even other people will be insulting her that you are living with him without having a child maybe he is barren that’s why you are not having a child with him. Most of the female participants were worried about their own health, and what future buy LY2510924 pregnancies could do to their health. They were mainly concerned with looking after the children they had. Furthermore, they were concerned about potential infection of their infants. Several participants had given birth to HIV-infected infants and did not want to repeat the experience. Others were waiting on HIV results for their newly born infants and were distressed at the thought that they could be infected. Though some of the male participants shared these health concerns, they were further influenced by the desire to have heirs and me.Id they did not want any more children. One male participant was not sure whether he wanted more children. Hence more men (9/12) than women wanted to have children. However, regardless of the differences in desire to have children, almost all of the PLHIV had made a reassessment of their ability to have more children and generally accepted that they could not have as many as they wanted. There was generally high level of knowledge around HIV transmission, particularly MTCT of HIV. Thus the decisionmaking process around having children was complex: the men and women interviewed knew the implications of having children, given their HIV status and the possibility of infecting their children. The themes around the desire to have children among the 26 participants included decision making (reassessment of reproductive career, male dominance and fatalism), external influences (spouses, family and health workers, and access to HAART and PMTCT services), culturalinfluences (heirs and inheritance), health concerns (personal health concerns and concerns for children’s health), stigma and attitudes to children (as sources of joy, utilitarian roles, strengthening marriages). Children were seen as sources of joy and blessings by most of the participants. The participants who had delivered children after their HIV diagnosis were pleased that they could have children and were particularly happy when they had HIV-negative children. Other participants spoke about the utilitarian function of children and how they would be a help in the future. A widow and mother of five children encapsulated the utilitarian function of children when she said: If they grow up they will also help you when you are now helpless. They will take you to hospital if you are very sick, dig for you, feed you and give you other help. Several female participants emphasized the role of children in strengthening marriages. A 20-year-old female participant, said: I think in marriage it means a lot to have children, because it makes a happy marriage, increase love among the two people. However, it was not just women who felt that children were essential for cementing relationships. Although several male participants had children with former spouses, they wanted to have children with their current partners. One male participant said that people would mock and query their inability to have children and this would lead to the wife deserting him: To my wife the issue is even more important because if you don’t have children with a woman she will not agree to live with you . . . The reason why I want to have a child is if you have a woman and don’t bear children with her your relationship will not be strong or good. Even other people will be insulting her that you are living with him without having a child maybe he is barren that’s why you are not having a child with him. Most of the female participants were worried about their own health, and what future pregnancies could do to their health. They were mainly concerned with looking after the children they had. Furthermore, they were concerned about potential infection of their infants. Several participants had given birth to HIV-infected infants and did not want to repeat the experience. Others were waiting on HIV results for their newly born infants and were distressed at the thought that they could be infected. Though some of the male participants shared these health concerns, they were further influenced by the desire to have heirs and me.