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Despite the growing importance of fertility issues for HIV-infected persons, little is known about their actual fertility desires and intentions. This study was, therefore, aimed at assessing fertility desires and demand for family planning in HIV-positive clients in follow-up care at antiretroviral treatment (ART) unit in Gondar University Hospital, Ethiopia. A cross sectional quantitative study on 389 study subjects (56% females and 44% males living with HIV/AIDS in follow-up care) supplemented by in-depth interview was conducted between November 2007 and January 2008. Eighty-five (49.71%) of the male and seventy-nine (36.3%) of the female participants expressed the desire for children, giving a total of 164 (42.16%) of all participants. Study subjects who had no children and whose partners wants children were more likely to have children desire. During the survey period, 100 (25.7%) of the clients were using different forms of family planning devices and 124 (42.9%) wants to use family planning in the future. The extent of fertility desire and family planning needs of these people has implication for vertical and heterosexual transmission of HIV, the needs for fertility-related counselling, and/or contraception, and advice regarding childbirth. [ABSTRACT FROM PUBLISHER]