En you die and these children are left in their hands, they mistreat them, saying they are positive. . . Agents and their impact on desire to have children among PLHIV The findings also revealed that the family, community and health system could either support or discourage the desire to have children among PLHIV. Some participants reported receiving family support for their decision to have more children. When asked about how his mother and other immediate family members felt about him having more children after his HIV-positive diagnosis, one male participant said: They have no objection because they are the one who suggested that I get a child at least and the women that I have now. Community members could also reinforce stigmatization of PLHIV. Some participants said that they faced verbal abuse and mocking from neighbours, with some of their children being called “HIV-positive children”. One male participant said that his neighbours told him that he should stop having children. Another male participant was asked by community members: You are HIV-positive, why do you want a child?A female participant expressed the difficulty she experienced: Yes, they were saying such people should no longer bear children, but nature is very hard to control especially if you have a man, you can only stop bearing children if you separate. As described earlier, one participant had also AZD0156 site experienced BLU-554 site stigmatizing comments from health workers. Thus some staff members had judgmental attitudes towards PLHIV who had the desire to have more children. Participants who reported that they did not experience hostility towards them as a result of their decisions to have more children were more likely to have positive attitudes towards participation in health services. Some pregnant women and their partners who were well received at the health facilities said they did not face stigmatization. One male participant said: They [the health workers at the hospital] welcomed us very warmly when they saw that I accompanied her for ANC. . .. No, there was no difficulties which I experienced at all because they served me eagerly, you know there are some men who are reluctant to accompany their wives to the hospital if their wife asks them and this is very challenging to the health workers. The health workers’ reactions also depended on PLHIVs willingness to disclose their status, according to one male participant: When she went for ANC she was received well and attended to because she was open to them. . .. There was no problem at all. This was confirmed by his wife: The health workers were friendly and after disclosing to them our status they were very supportive and counselled me and also emphasised the need for me to continue with my ANC visits. Another male participant reiterated this, saying: The medical staff received us with a lot of hospitality, because they knew that I am HIV-positive, and as I have taken my wife for ANC, they were very pleased because we went together, she did not go un-accompanied. Health systems and facilities also mitigated HIV-related stigma through their role in reducing disease-related symptoms and overt manifestations of HIV/AIDS. By reducing overt manifestations of HIV/AIDS, HAART restored the health and vitality of PLHIV. As a result, negative thoughts decreased, allowing some participants to feel more positive at the prospect of starting new relationships and having more children. As one male participant said: It changed and I stayed f.En you die and these children are left in their hands, they mistreat them, saying they are positive. . . Agents and their impact on desire to have children among PLHIV The findings also revealed that the family, community and health system could either support or discourage the desire to have children among PLHIV. Some participants reported receiving family support for their decision to have more children. When asked about how his mother and other immediate family members felt about him having more children after his HIV-positive diagnosis, one male participant said: They have no objection because they are the one who suggested that I get a child at least and the women that I have now. Community members could also reinforce stigmatization of PLHIV. Some participants said that they faced verbal abuse and mocking from neighbours, with some of their children being called “HIV-positive children”. One male participant said that his neighbours told him that he should stop having children. Another male participant was asked by community members: You are HIV-positive, why do you want a child?A female participant expressed the difficulty she experienced: Yes, they were saying such people should no longer bear children, but nature is very hard to control especially if you have a man, you can only stop bearing children if you separate. As described earlier, one participant had also experienced stigmatizing comments from health workers. Thus some staff members had judgmental attitudes towards PLHIV who had the desire to have more children. Participants who reported that they did not experience hostility towards them as a result of their decisions to have more children were more likely to have positive attitudes towards participation in health services. Some pregnant women and their partners who were well received at the health facilities said they did not face stigmatization. One male participant said: They [the health workers at the hospital] welcomed us very warmly when they saw that I accompanied her for ANC. . .. No, there was no difficulties which I experienced at all because they served me eagerly, you know there are some men who are reluctant to accompany their wives to the hospital if their wife asks them and this is very challenging to the health workers. The health workers’ reactions also depended on PLHIVs willingness to disclose their status, according to one male participant: When she went for ANC she was received well and attended to because she was open to them. . .. There was no problem at all. This was confirmed by his wife: The health workers were friendly and after disclosing to them our status they were very supportive and counselled me and also emphasised the need for me to continue with my ANC visits. Another male participant reiterated this, saying: The medical staff received us with a lot of hospitality, because they knew that I am HIV-positive, and as I have taken my wife for ANC, they were very pleased because we went together, she did not go un-accompanied. Health systems and facilities also mitigated HIV-related stigma through their role in reducing disease-related symptoms and overt manifestations of HIV/AIDS. By reducing overt manifestations of HIV/AIDS, HAART restored the health and vitality of PLHIV. As a result, negative thoughts decreased, allowing some participants to feel more positive at the prospect of starting new relationships and having more children. As one male participant said: It changed and I stayed f.